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Al-Hassi HO, Ali NM, Cooke H, De Silva S, Brini AT, Babu P, Sumathi V, Morris MR, Niada S. FGF23 Expression Is a Promising Immunohistochemical Diagnostic Marker for Undifferentiated Pleomorphic Sarcoma of Bone (UPSb). Genes (Basel) 2024; 15:242. [PMID: 38397231 PMCID: PMC10887495 DOI: 10.3390/genes15020242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/09/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Undifferentiated pleomorphic sarcoma of bone (UPSb) is a rare primary bone sarcoma that lacks a specific line of differentiation. Distinguishing between UPSb and other malignant bone sarcomas, including dedifferentiated chondrosarcoma and osteosarcoma, is challenging due to their overlapping features. We have previously identified that UPSb tumours have elevated mRNA levels of Fibroblast Growth Factor 23 (FGF23) transcripts compared to other sarcomas including osteosarcoma. In the present study, we evaluated the specificity and practicality of FGF23 immunoreactivity as a specific diagnostic tool to differentiate UPSb tumours from osteosarcomas and dedifferentiated chondrosarcomas. Methods: A total of 10 UPSb, 10 osteosarcoma, and 10 dedifferentiated chondrosarcoma cases (all high-grade), were retrieved and immunohistochemistry for FGF23 was performed. Results: FGF23 protein was expressed at high levels in 80-90% of undifferentiated pleomorphic sarcoma of the bone cases, whereas it was expressed at significantly lower levels in dedifferentiated chondrosarcoma and osteosarcoma cases. A semiquantitative analysis, considering the intensity of immunoreactivity, confirmed significantly elevated FGF23 expression levels in UPSb tissues compared to those observed in osteosarcoma and dedifferentiated chondrosarcoma tissues. Conclusions: The results we present here suggest that FGF23 immunohistochemistry may be a useful tool to aid in differentiating UPSb from morphologically similar malignant bone sarcomas, especially in situations where sampling is restricted and there is limited clinical information available.
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Affiliation(s)
- Hafid O. Al-Hassi
- Research Institute of Healthcare Science, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton WV1 1LY, UK; (H.C.); (M.R.M.)
| | - Naser M. Ali
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;
- Department of Medical Laboratories, General Ahmadi Hospital (KOC Hospital), Ahmadi 61008, Kuwait
| | - Hannah Cooke
- Research Institute of Healthcare Science, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton WV1 1LY, UK; (H.C.); (M.R.M.)
| | - Shamini De Silva
- Research Institute of Healthcare Science, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton WV1 1LY, UK; (H.C.); (M.R.M.)
| | - Anna T. Brini
- Laboratory of Biotechnological Applications, IRCCS Orthopedic Institute Galeazzi, 20157 Milan, Italy;
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy
| | - Pavithra Babu
- Acute Medicine, Birmingham Heartlands Hospital, University Hospital Birmingham, Birmingham B9 5SS, UK;
| | - Vaiyapuri Sumathi
- Department of Musculoskeletal Pathology, University Hospital of Birmingham, Birmingham B15 2TT, UK;
| | - Mark R. Morris
- Research Institute of Healthcare Science, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton WV1 1LY, UK; (H.C.); (M.R.M.)
| | - Stefania Niada
- Laboratory of Biotechnological Applications, IRCCS Orthopedic Institute Galeazzi, 20157 Milan, Italy;
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2
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Sahito B, Shah HH, Zehra SA, Saquib J, Ahmed F, Hussain MS, Dave T. Distal radius chondrosarcoma in a 35-year-old female patient: A case report. Clin Case Rep 2023; 11:e8069. [PMID: 37881195 PMCID: PMC10593975 DOI: 10.1002/ccr3.8069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023] Open
Abstract
Key Clinical Message Chondrosarcoma, although rare in the distal radius, poses significant challenges. Early diagnosis through incisional biopsy is essential. Surgical resection with margin control and fibular grafting can be effective, but vigilant surveillance is crucial due to its aggressive nature. Metastasis demands consideration of additional interventions or palliative care. Abstract Chondrosarcomas constitute a rarity in the upper limbs, and their occurrence in the distal radius is even rarer with only one case previously documented. We report a case of distal radius chondrosarcoma in a 35-year-old female patient who presented with pain and swelling in her left wrist. Following an initial examination, an incisional biopsy was performed, confirming the diagnosis of dedifferentiated chondrosarcoma. The patient underwent a marginal resection of the distal radius and first carpal with ipsilateral fibular and locking compression plate fixation. Unfortunately, despite the interventions, the patient experienced recurrent swelling and ultimately required below-elbow amputation, followed by above elbow amputation due to metastasis. Unfortunately, the patient passed away due to recurrence and metastasis.
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Affiliation(s)
- Badaruddin Sahito
- Head of Orthopedics departmentDr Ruth K M Pfau Civil Hospital KarachiKarachiPakistan
| | | | | | - Javeria Saquib
- Dow Medical CollegeDr Ruth K M Pfau Civil Hospital KarachiKarachiPakistan
| | - Farea Ahmed
- Dow Medical CollegeDr Ruth K M Pfau Civil Hospital KarachiKarachiPakistan
| | | | - Tirth Dave
- Bukovinian State Medical UniversityChernivtsiUkraine
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3
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Bui N, Dietz H, Farag S, Hirbe AC, Wagner MJ, Van Tine BA, Ganjoo K, Jones RL, Keedy VL, Davis EJ. A Retrospective Multi-Institutional Cohort Analysis of Clinical Characteristics and Outcomes in Dedifferentiated Chondrosarcoma. Cancers (Basel) 2023; 15:cancers15092617. [PMID: 37174084 PMCID: PMC10177459 DOI: 10.3390/cancers15092617] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Dedifferentiated chondrosarcoma (DDCS) is a rare subset of chondrosarcoma. It is an aggressive neoplasm characterized by a high rate of recurrent and metastatic disease with overall poor outcomes. Systemic therapy is often used to treat DDCS; however, the optimal regimen and timing are not well defined, with current guidelines recommending following osteosarcoma protocols. METHODS We conducted a multi-institutional retrospective analysis of clinical characteristics and outcomes of patients with DDCS. Between 1 January 2004 and 1 January 2022, the databases from five academic sarcoma centers were reviewed. Patient and tumor factors, including age, sex, tumor size, site, location, the treatments rendered, and survival outcomes, were collected. RESULTS Seventy-four patients were identified and included in the analysis. Most patients presented with localized disease. Surgical resection was the mainstay of therapy. Chemotherapy was used predominantly in the metastatic setting. Partial responses were low (n = 4; 9%) and occurred upon treatment with doxorubicin with cisplatin or ifosfamide and single-agent pembrolizumab. For all other regimens, stable disease was the best response. Prolonged stable disease occurred with the use of pazopanib and immune checkpoint inhibitors. CONCLUSIONS DDCS has poor outcomes and conventional chemotherapy has limited benefit. Future studies should focus on defining the possible role of molecularly targeted therapies and immunotherapy in the treatment of DDCS.
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Affiliation(s)
- Nam Bui
- Stanford Cancer Institute, Palo Alto, CA 94304, USA
| | - Hilary Dietz
- Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Sheima Farag
- Institute of Cancer Research, Royal Marsden Hospital, London SW3 6JJ, UK
| | - Angela C Hirbe
- Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Michael J Wagner
- Fred Hutchinson Cancer Center, University of Washington, Seattle, WA 98109, USA
| | - Brian A Van Tine
- Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO 63110, USA
| | | | - Robin L Jones
- Institute of Cancer Research, Royal Marsden Hospital, London SW3 6JJ, UK
| | - Vicki L Keedy
- Vanderbilt University Medical Center, Nashville, TN 37232, USA
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4
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Hung YP, Chebib I, Bredella MA, Berner EA, Taylor-Black Q, Choy E, Cote GM, Chen YL, MacDonald SM, Schwab JH, Raskin KA, Newman ET, Selig MK, Deshpande V, Hornick JL, Lozano-Calderón SA, Nielsen GP. Prognostic Significance of Percentage and Size of Dedifferentiation in Dedifferentiated Chondrosarcoma. Mod Pathol 2023; 36:100069. [PMID: 36788104 DOI: 10.1016/j.modpat.2022.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/17/2022] [Accepted: 12/11/2022] [Indexed: 01/11/2023]
Abstract
Dedifferentiated chondrosarcoma is rare, aggressive, and microscopically bimorphic. How pathologic features such as the amounts of dedifferentiation affect prognosis remains unclear. We evaluated the percentages and sizes of dedifferentiation in a consecutive institutional series of dedifferentiated chondrosarcomas from 1999 to 2021. The statistical analysis included cox proportional hazard models and log-rank tests. Of the 67 patients (26 women, 41 men; age, 39 to >89 [median 61] years; 2 with Ollier disease), 58 presented de novo; 9 were identified with conventional chondrosarcomas 0.6-13.2 years (median, 5.5 years) prior. Pathologic fracture and distant metastases were noted in 27 and 7 patients at presentation. The tumors involved the femur (n = 27), pelvis (n = 22), humerus (n = 7), tibia (n = 4), scapula/ribs (n = 4), spine (n = 2), and clivus (n = 1). In the 56 resections, the tumors ranged in size from 3.5 to 46.0 cm (median, 11.5 cm) and contained 1%-99.5% (median, 70%) dedifferentiated components that ranged in size from 0.6 to 24.0 cm (median, 7.3 cm). No correlation was noted between total size and percentage of dedifferentiation. The dedifferentiated components were typically fibrosarcomatous or osteosarcomatous, whereas the associated cartilaginous components were predominantly grade 1-2, rarely enchondromas or grade 3. The entire cohort's median overall survival and progression-free survival were 11.8 and 5.4 months, respectively. In the resected cohort, although the total size was not prognostic, the percentage of dedifferentiation ≥20% and size of dedifferentiation >3.0 cm each predicted worse overall survival (9.9 vs 72.5 months; HR, 3.76; 95% CI, 1.27-11.14; P = .02; 8.7 vs 58.9 months; HR, 3.03; 95% CI, 1.21-7.57; P = .02, respectively) and progression-free survival (5.3 vs 62.1 months; HR, 3.05; 95% CI, 1.13-8.28; P = .03; 5.3 vs 56.6 months; HR, 2.50; 95% CI, 1.06-5.88; P = .04, respectively). In conclusion, both the percentages and sizes of dedifferentiation were better prognostic predictors than total tumor sizes in dedifferentiated chondrosarcomas, highlighting the utility of their pathologic evaluations.
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Affiliation(s)
- Yin P Hung
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts.
| | - Ivan Chebib
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Miriam A Bredella
- Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Emily A Berner
- Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Quinn Taylor-Black
- Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Edwin Choy
- Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Division of Hematology Oncology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Gregory M Cote
- Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Division of Hematology Oncology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Yen-Lin Chen
- Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Shannon M MacDonald
- Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Joseph H Schwab
- Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kevin A Raskin
- Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Erik T Newman
- Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Martin K Selig
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Vikram Deshpande
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Santiago A Lozano-Calderón
- Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - G Petur Nielsen
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
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5
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Gusho CA, Lee L, Zavras A, Seikel Z, Miller I, Colman MW, Gitelis S, Blank AT. Dedifferentiated Chondrosarcoma: A Case Series and Review of the Literature. Orthop Rev (Pavia) 2022; 14:35448. [PMID: 35769663 PMCID: PMC9235431 DOI: 10.52965/001c.35448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/05/2022] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Dedifferentiated chondrosarcoma (DCS) is a rare and aggressive malignancy with a poor prognosis. The purpose of this investigation was to describe our treatment and outcomes of 16 DCS patients at our institution and provide a review of the current literature. METHODS This study was a retrospective review over a consecutive twenty-year period. Data including treatment details and outcomes were recorded. RESULTS A total of 16 cases from 2000 to 2018 were identified. The median age (IQR) was 62 years (52; 69) and the majority of DCS arose in the femur (50%, n=8) and pelvis (25%, n=4). Fourteen (88%) cases underwent limb salvage/wide margin resection (n=13) or intralesional surgery (n=1). For all DCS, the median survival (IQR) was 46 months (12; 140), with both a five and ten-year probability of 32.1% (95% CI, 7.3% to 57.0%). At study conclusion, 81.3% (n=13) were deceased and 18.7% (n=3) were alive. CONCLUSIONS Our findings confirm the poor prognosis of DCS patients, with a five-year estimate of 32%. Together with existing literature, our data might help enable future strategic recommendation of these patients.
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Affiliation(s)
| | - Linus Lee
- Orthopedic Surgery, Rush University Medical Center
| | - Athan Zavras
- Orthopedic Surgery, Rush University Medical Center
| | | | - Ira Miller
- Pathology, Rush University Medical Center
| | | | | | - Alan T Blank
- Orthopedic Surgery, Rush University Medical Center
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6
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Kozawa E, Nishida Y, Kawai A, Hayakawa K, Nokitaka S, Kawashima H, Iwata S, Tsuchiya H, Tsukushi S, Takenaka S, Imanishi J, Baba I, Nagano A, Morii T, Shirai T, Shimizu K, Kawano H. Clinical features and treatment outcomes of dedifferentiated and grade 3 chondrosarcoma: A multi-institutional study. Cancer Sci 2022; 113:2397-2408. [PMID: 35485870 PMCID: PMC9277248 DOI: 10.1111/cas.15382] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/18/2022] [Accepted: 04/22/2022] [Indexed: 11/29/2022] Open
Abstract
Chondrosarcoma is the second most common primary malignant bone tumor. In this multicenter study, we sought to evaluate the (i) disease-specific survival (DSS) and disease-free survival (DFS), and (ii) prognostic factors in patients with dedifferentiated chondrosarcoma (DDCS) and grade 3 chondrosarcoma (G3CS) in Japan. We retrospectively investigated the treatment outcomes and prognostic factors in 62 patients with DDCS and 19 patients with G3CS at 15 institutions participating in the Japanese Musculoskeletal Oncology Group. We also clarified significant clinico-pathological factors for oncological outcomes. In surgery for primary lesions aimed at cure, a histologically negative margin (R0) was obtained in 93% (14/15) of patients with G3CS and 100% (49/49) of patients with DDCS. The 5-year DSS was 18.5% in patients with DDCS and 41.7% in patients with G3CS (P = 0.13). Local control was obtained in 80% (12/15) and 79.6% (39/49) of patients with G3CS and DDCS in the primary lesion after surgery with a wide surgical margin, respectively. In multivariate analysis, stage and no treatment/palliative treatment for the primary lesion were independent prognostic factors for DSS of DDCS, age and no treatment/palliative treatment for DSS of G3CS. The 5-year DFS rate was 22.8% in 26 patients with DDCS who did not receive adjuvant chemotherapy, and 21.4% in 14 patients who received adjuvant chemotherapy. The prognosis of DDCS remains poor, although R0 resection was performed in most cases. Effective and/or intensive chemotherapeutic regimens or agents should be considered or developed for patients with high-grade chondrosarcoma, particularly for those with DDCS.
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Affiliation(s)
- Eiji Kozawa
- Department of Orthopaedic Surgery, Nagoya Memorial Hospital, Nagoya, Japan
| | - Yoshihiro Nishida
- Department of Rehabilitation Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Akira Kawai
- Division of Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Keiko Hayakawa
- Department of Orthopedic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Setsu Nokitaka
- Department of Orthopedics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Orthopedic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Shintaro Iwata
- Division of Orthopedic Surgery, Chiba Cancer Center, Chiba, Japan.,Division of Orthopedic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Satoshi Tsukushi
- Department of Orthopedic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Satoshi Takenaka
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Department of Musculoskeletal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Jungo Imanishi
- Department of Orthopaedic Oncology and Surgery, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan.,Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Ichiro Baba
- Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Akihito Nagano
- Department of Orthopaedic Surgery, Gifu University, Gifu, Japan
| | - Takeshi Morii
- Department of Orthopedic Surgery, Kyorin University, Tokyo, Japan
| | - Toshiharu Shirai
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koki Shimizu
- Department of Orthopaedic Surgery, Nagoya Memorial Hospital, Nagoya, Japan
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
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7
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Li X, Dean DC, Ferreira A, Nelson SD, Hornicek FJ, Yu S, Duan Z. Establishment and Characterization of a Novel Dedifferentiated Chondrosarcoma Cell Line DDCS2. Cancer Control 2021; 28:10732748211045274. [PMID: 34767468 PMCID: PMC8645311 DOI: 10.1177/10732748211045274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The dedifferentiated variant of chondrosarcoma is highly aggressive and carries an especially grim prognosis. While chemotherapeutics has failed to benefit patients with dedifferentiated chondrosarcoma significantly, preclinical chemosensitivity studies have been limited by a scarcity of available cell lines. There is, therefore, an urgent need to expand the pool of available cell lines. Methods We report the establishment of a novel dedifferentiated chondrosarcoma cell line DDCS2, which we isolated from the primary tumor specimen of a 60-year-old male patient. We characterized its short tandem repeat (STR) DNA profile, growth potential, antigenic markers, chemosensitivity, and oncogenic spheroid and colony-forming capacity. Results DDCS2 showed a spindle to polygonal shape and an approximate 60-hour doubling time. STR DNA profiling revealed a unique genomic identity not matching any existing cancer cell lines within the ATCC, JCRB, or DSMZ databases. There was no detectable contamination with another cell type. Western blot and immunofluorescence assays were consistent with a mesenchymal origin, and our MTT assay revealed relative resistance to conventional chemotherapeutics, which is typical of a dedifferentiated chondrosarcoma. Under ex vivo three-dimensional (3D) culture conditions, the DDCS2 cells produced spheroid patterns similar to the well-established CS-1 and SW1353 chondrosarcoma cell lines. Conclusion Our findings confirm DDCS2 is a novel model for dedifferentiated chondrosarcoma and therefore adds to the limited pool of current cell lines urgently needed to investigate the chemoresistance within this deadly cancer.
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Affiliation(s)
- Xiaoyang Li
- Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, 71041Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.,Sarcoma Biology Laboratory, Department of Orthopaedics, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine, Miami, FL 33136
| | - Dylan C Dean
- Sarcoma Biology Laboratory, Department of Orthopaedics, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine, Miami, FL 33136
| | - Al Ferreira
- Sarcoma Biology Laboratory, Department of Orthopaedics, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine, Miami, FL 33136
| | - Scott D Nelson
- Sarcoma Biology Laboratory, Department of Orthopaedic Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA 90095
| | - Francis J Hornicek
- Sarcoma Biology Laboratory, Department of Orthopaedics, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine, Miami, FL 33136
| | - Shengji Yu
- Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, 71041Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Zhenfeng Duan
- Sarcoma Biology Laboratory, Department of Orthopaedics, Sylvester Comprehensive Cancer Center, and the University of Miami Miller School of Medicine, Miami, FL 33136
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8
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Kattepur AK, Jones RL, Gulia A. Dedifferentiated chondrosarcoma: current standards of care. Future Oncol 2021; 17:4983-4991. [PMID: 34734747 DOI: 10.2217/fon-2021-0830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Dedifferentiated chondrosarcomas are aggressive variants of chondrosarcoma, associated with poor outcomes. Tumor biphasism is the norm. The majority of these tumors are symptomatic at presentation. Radiologically, large soft tissue masses with bony destruction predominate. Treatment protocols of these tumors are not well defined. Surgical resection forms the standard of care for localized disease. (Neo)adjuvant therapies remain controversial as the results from multiple (mainly retrospective) studies remain conflicting. Age at presentation, stage and ability to obtain negative resection margins are important prognostic factors. The overall prognosis is dismal. Newer and novel therapies targeting the complex genetic makeup of these tumors have renewed interest in the adjuvant setting that could hold promise in the near future.
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Affiliation(s)
- Abhay K Kattepur
- Department of Surgical Oncology, Sri Devaraj Urs Academy of Higher Education & Research, Tamaka, Kolar 563101, Karnataka, India
| | - Robin L Jones
- Consultant Medical Oncologist, Royal Marsden Hospital NHS Trust, 203 Fulham Rd, London SW3 6JJ, UK
| | - Aashish Gulia
- Department of Surgical Oncology, Tata Memorial Hospital & Homi Bhabha National Institute (HBNI), Parel, Mumbai 400012, India
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9
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Gaeta R, Aringhieri G, Zampa V, D'Arienzo A, Andreani L, Capanna R, Zavaglia K, Franchi A. Acral Dedifferentiated Chondrosarcoma: Report of a Case Arising in the Proximal Phalanx of the Fourth Finger. Int J Surg Pathol 2021; 29:892-898. [PMID: 33847539 DOI: 10.1177/10668969211010221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dedifferentiated chondrosarcoma is a well-recognized entity, but its occurrence in the distal extremities is exceedingly rare. We present the case of a 49-year-old woman who experienced local recurrence of an "enchondroma" of the proximal phalanx of the fourth finger of the left hand, which had been initially treated with intralesional curettage at another hospital 4 years before, and 1 year before for a local recurrence. The imaging findings indicated an aggressive behavior, and an incisional biopsy showed a highly cellular proliferation of spindle and pleomorphic elements without evidence of matrix production intermixed with few fragments of a well-differentiated cartilaginous neoplasm with bland cellular atypia, focal nuclear hyperchromatism, and binucleation. An isocitrate dehydrogenase 2 R172S mutation was detected. The final diagnosis was dedifferentiated chondrosarcoma. Despite amputation of the fourth finger, the patient developed lung metastases and further local relapse. Recurrent cartilaginous tumors of the extremities should not be underestimated and should be followed in view of the possible acquisition of aggressive clinical behavior.
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Affiliation(s)
- Raffaele Gaeta
- 9310Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giacomo Aringhieri
- 9310Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Virna Zampa
- Department of Diagnostics and Imaging, Pisa University Hospital, Pisa, Italy
| | - Antonio D'Arienzo
- 2nd Orthopedic and Traumatology Clinic, Pisa University Hospital, Pisa, Italy
| | - Lorenzo Andreani
- 2nd Orthopedic and Traumatology Clinic, Pisa University Hospital, Pisa, Italy
| | - Rodolfo Capanna
- 9310Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Katia Zavaglia
- Division of Molecular Genetics, Department of Laboratory Medicine, Pisa University Hospital, Pisa, Italy
| | - Alessandro Franchi
- 9310Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Liu C, Xing Y, Jiao Q, Yang Q, Yu W, Li Y, Tao X, Yao W. Association of Preoperative Neutrophil/Lymphocyte Ratio with Clinical Outcomes in Dedifferentiated Chondrosarcoma Patients. Cancer Manag Res 2020; 12:6719-6726. [PMID: 32848454 PMCID: PMC7425651 DOI: 10.2147/cmar.s266671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/17/2020] [Indexed: 11/24/2022] Open
Abstract
Background Dedifferentiated chondrosarcoma (DC) is an extremely uncommon malignant bone tumor with dismal survival outcomes. The purpose of this study was to investigate whether the preoperative neutrophil/lymphocyte ratio (NLR) has the ability to predict overall survival (OS) in DC patients. Materials and Methods Twenty-three DC patients with surgical resection were retrospectively reviewed between 2008 and 2015. The clinical pathological information and survival data were collected for analysis. The cut-off point for NLR was defined by receiver operating curve (ROC). The impact of NLR level on OS between two groups was compared using Kaplan–Meier curves with the Log-rank test. The association between NLR and OS was calculated by univariate and multivariate Cox proportional models. Results From the ROC analysis, the optimal NLR cut-off point was 3.11. Patients with high NLR had a worse OS than low NLR (p = 0.003, Log-rank test). In univariate analysis, a significant association was observed between high NLR and poor OS (Hazard ratio (HR) 4.62, 95% confidence interval (CI) 1.48–14.34, p = 0.008). After adjustment of co-variables, high NLR had more than 4 times the risk of mortality (HR 4.01, 95% CI 1.12–14.26, p = 0.032). Conclusion Preoperative NLR in peripheral blood is an easily accessible and cost-effective prognostic biomarker in DC patients. A prospective study with large sample size is warranted.
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Affiliation(s)
- Chenglei Liu
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yue Xing
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Qiong Jiao
- Department of Pathology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Qingcheng Yang
- Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Wenbin Yu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Head and Neck Surgery, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Yuncheng Li
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Weiwu Yao
- Department of Radiology, Shanghai Tongren Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, People's Republic of China
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Mohammad N, Wong D, Lum A, Lin J, Ho J, Lee CH, Yip S. Characterisation of isocitrate dehydrogenase 1/isocitrate dehydrogenase 2 gene mutation and the d-2-hydroxyglutarate oncometabolite level in dedifferentiated chondrosarcoma. Histopathology 2020; 76:722-730. [PMID: 31609487 DOI: 10.1111/his.14018] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/11/2019] [Indexed: 11/29/2022]
Abstract
AIMS Dedifferentiated chondrosarcoma (DDCHS) is an aggressive type of chondrosarcoma that results from high-grade transformation of a low-grade chondrosarcoma. Mutations in the isocitrate dehydrogenase (IDH) 1 gene and the IDH2 gene that lead to increased d-2-hydroxyglutarate (2HG) oncometabolite production, promoting tumorigenesis, have been recently described in low-grade cartilaginous neoplasms. The aims of this study were to examine the prevalence of IDH mutations in a single-institution cohort of DDCHS cases and correlate 2HG levels with mutation status. METHODS AND RESULTS We examined a series of 21 primary DDCHS cases by using Sanger sequencing and quantitative polymerase chain reaction genotyping to look for IDH1/IDH2 mutations, and evaluated the 2HG levels in formalin-fixed paraffin-embedded tumour and matched normal tissue samples by using a fluorometric assay. Seventy-six per cent of DDCHS cases (16/21) harboured a heterozygous IDH1 or IDH2 mutation. Six of 14 IDH-mutated DDCHS cases showed elevated 2HG levels in tumour tissue relative to matched normal tissue. There were no consistent histological or disease-specific survival differences between IDH-mutated tumours and wild-type tumours. CONCLUSIONS Our study confirms the frequent presence of a variety of IDH1 and IDH2 mutation variants, indicating that a sequencing-based approach is required for DDCHS if IDH is to be used as a diagnostic marker. Similarly to other IDH-mutated tumour types, IDH-mutated DDCHS cases show elevated 2HG levels, indicating that the oncometabolite activity of 2HG may contribute to DDCHS oncogenesis and progression.
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Affiliation(s)
- Nissreen Mohammad
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Derek Wong
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Amy Lum
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, BC, Canada
| | - Jonah Lin
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Julie Ho
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Cheng-Han Lee
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, BC, Canada
| | - Stephen Yip
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, BC, Canada
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12
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Nemecek E, Funovics PT, Hobusch GM, Lang S, Willegger M, Sevelda F, Brodowicz T, Stihsen C, Windhager R, Panotopoulos J. C-reactive protein: An independent predictor for dedifferentiated chondrosarcoma. J Orthop Res 2018; 36:2797-2801. [PMID: 29701260 PMCID: PMC6220779 DOI: 10.1002/jor.24030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 04/17/2018] [Indexed: 02/04/2023]
Abstract
Dedifferentiated chondrosarcoma is a rare primary bone malignancy with a very poor prognosis. The aim of the study was to identify pretreatment serum markers as prognostic factors for the overall survival (OS) of patients with dedifferentiated chondrosarcoma. We retrospectively reviewed 33 patients with histologically confirmed dedifferentiated chondrosarcoma treated at our department from 1977 to 2015. Kaplan-Meier estimation, uni- and multivariable Cox proportional hazard model were performed to evaluate the association between serum markers such as the C-reactive protein and OS. In univariable analysis, CRP was strongly associated with OS (HR 1.35; 95%CI 1.13-1.61; p = 0.001). This association prevailed after adjustment for AJCC tumor stage (HR 1.31; 95%CI 1.02-1.57; p = 0.031) in multivariable analysis. In conclusion, our data gave evidence that baseline CRP is an independent predictor for OS in patients with dedifferentiated chondrosarcoma. CRP could be exploited for the clinical prediction of this disease in the future. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 36:2797-2801, 2018.
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Affiliation(s)
- Elena Nemecek
- Department of Orthopaedics and TraumatologyClinical Division of Orthopaedics, Medical University of ViennaWähringer Gürtel 18‐20, A‐1090 ViennaAustria
| | - Philipp Theodor Funovics
- Department of Orthopaedics and TraumatologyClinical Division of Orthopaedics, Medical University of ViennaWähringer Gürtel 18‐20, A‐1090 ViennaAustria
| | - Gerhard Martin Hobusch
- Department of Orthopaedics and TraumatologyClinical Division of Orthopaedics, Medical University of ViennaWähringer Gürtel 18‐20, A‐1090 ViennaAustria
| | - Susanna Lang
- Clinical Institute of PathologyMedical University of ViennaViennaAustria
| | - Madeleine Willegger
- Department of Orthopaedics and TraumatologyClinical Division of Orthopaedics, Medical University of ViennaWähringer Gürtel 18‐20, A‐1090 ViennaAustria
| | - Florian Sevelda
- Department of Orthopaedics and TraumatologyClinical Division of Orthopaedics, Medical University of ViennaWähringer Gürtel 18‐20, A‐1090 ViennaAustria
| | - Thomas Brodowicz
- Department of Medicine I, Clinical Division of OncologyMedical University of ViennaViennaAustria
| | - Christoph Stihsen
- Department of Orthopaedics and TraumatologyClinical Division of Orthopaedics, Medical University of ViennaWähringer Gürtel 18‐20, A‐1090 ViennaAustria
| | - Reinhard Windhager
- Department of Orthopaedics and TraumatologyClinical Division of Orthopaedics, Medical University of ViennaWähringer Gürtel 18‐20, A‐1090 ViennaAustria
| | - Joannis Panotopoulos
- Department of Orthopaedics and TraumatologyClinical Division of Orthopaedics, Medical University of ViennaWähringer Gürtel 18‐20, A‐1090 ViennaAustria
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Strotman PK, Reif TJ, Kliethermes SA, Sandhu JK, Nystrom LM. Dedifferentiated chondrosarcoma: A survival analysis of 159 cases from the SEER database (2001-2011). J Surg Oncol 2017; 116:252-257. [PMID: 28420036 DOI: 10.1002/jso.24650] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 03/18/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES Dedifferentiated chondrosarcoma is a rare malignancy with reported 5-year overall survival rates ranging from 7% to 24%. The purpose of this investigation is to determine the overall survival of dedifferentiated chondrosarcoma in a modern patient series and how it is impacted by patient demographics, tumor characteristics, and surgical treatment factors. METHODS This is a retrospective review of the Surveillance, Epidemiology, and End Results (SEER) database from 2001 to 2011. Kaplan Meier analyses were used for overall and disease-specific survival. Univariable and multivariable cox regression models were used to identify prognostic factors. RESULTS Five year overall- and disease-specific survival was 18% (95% CI: 12-26%) and 28% (95% CI: 18-37%), respectively. Individuals with extremity tumors had a worse prognosis than individuals with a primary tumor in the chest wall or axial skeleton (HR 0.20, 95% CI: 0.07-0.56; P = 0.002 and HR 0.60, 95% CI: 0.36-0.99; P = 0.04, respectively). Patients with AJCC stage III or IV disease (HR 2.51, 95% CI: 1.50-4.20; P = 0.001), tumors larger than 8 cm (HR 2.17, 95% CI: 1.11-4.27; P = 0.046), metastatic disease at diagnosis (HR 3.25, 95% CI: 1.98-5.33; P < 0.001), and those treated without surgical resection (amputation: HR 0.43, 95% CI 0.23-0.80; P = 0.01; limb salvage/non-amputation resection: HR 0.41, 95% CI: 0.24-0.69; P = 0.001) had a significant increase in risk of mortality. CONCLUSIONS The overall prognosis of dedifferentiated chondrosarcoma is poor with a 5-year overall survival of 18%. Patients with a primary tumor located in the chest wall had a better prognosis. Tumors larger than 8 cm, presence of metastases at diagnosis, and treatment without surgical resection were significant predictors of mortality.
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Affiliation(s)
- Patrick K Strotman
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago, Maywood, Illinois
| | - Taylor J Reif
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago, Maywood, Illinois
| | | | - Jasmin K Sandhu
- Clinical Research Offices, Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois
| | - Lukas M Nystrom
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago, Maywood, Illinois
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