Histologic grading in soft‐tissue sarcomas. An analysis of 194 cases including agnor count and mast‐cell count

Tomita, Yoshihiro; Aozasa, Katsuyuki; Myoui, Akira; Kuratsu, Shigeyuki; Uchida, Atsushi; Ono, Kazuhisa; Matsumoto, Kazuya

doi:10.1002/ijc.2910540206

Cited by 39 publications

(36 citation statements)

References 27 publications

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“…Tumor necrosis has repeatedly been established as a negative prognostic factor in STS. 23,[30][31][32][33][34] It also represents an important factor in the FNCLCC and the NCI grading systems, which apply cutoff values of 15% (microscopic evaluation) and 50% (macroscopic evaluation), respectively. 35 In the SING model, necrosis is classified as present or absent based on histological examination, irrespective of the size of the tumor area, which is perceived as advantageous in relation to the risk of sampling bias.…”

Section: Discussionmentioning

confidence: 99%

A prognostic model for soft tissue sarcoma of the extremities and trunk wall based on size, vascular invasion, necrosis, and growth pattern

Carneiro

Bendahl

Engellau

et al. 2010

Cancer

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BACKGROUND:In soft tissue sarcoma, better distinction of high-risk and low-risk patients is needed to individualize treatment and improve survival. Prognostic systems used in clinical practice identify high-risk patients based on various factors, including age, tumor size and depth, histological type, necrosis, and grade. METHODS: Whole-tumor sections from 239 soft tissue sarcomas of the extremities were reviewed for the following prognostic factors: size, vascular invasion, necrosis, and growth pattern. A new prognostic model, referred to as SING (Size, Invasion, Necrosis, Growth), was established and compared with other clinically applied systems. RESULTS: Size, vascular invasion, necrosis, and peripheral tumor growth pattern provided independent prognostic information with hazard ratios of 2.2-2.6 for development of metastases in multivariate analysis. When these factors were combined into the prognostic model SING, high risk of metastasis was predicted with a sensitivity of 74% and a specificity of 85%. Moreover, the prognostic performance of SING compared favorably with other widely used systems. CONCLUSIONS: SING represents a promising prognostic model, and vascular invasion and tumor growth pattern should be considered in soft tissue sarcoma prognostication.

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Section: Discussionmentioning

confidence: 99%

A prognostic model for soft tissue sarcoma of the extremities and trunk wall based on size, vascular invasion, necrosis, and growth pattern

Carneiro

Bendahl

Engellau

et al. 2010

Cancer

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“…Although the prognosis of patients with STSs has improved, a subset of STSs shows an aggressive clinical course and results in tumorrelated mortality (1,2). Therefore, a number of studies have been designed to investigate the prognostic factors of STSs, such as Ki-67, p53, cyclin D1, EGFR, cyclin A, CD40, CD44, VEGF, EZH2, FOXO1, c-Myc, osteopontin, Bcl-2, ERBB2, KIT, IGF-1R and MCM2, since they may aid in determining the course of adjuvant therapy and the length of follow-up ).…”

Section: Discussionmentioning

confidence: 99%

“…STSs often display highly aggressive behavior with a tendency towards early metastasis. Although the same histological categories of STSs exist, various grades of malignancy with different prognosis are included (2). A variety of clinicopathological factors, such as tumor size, depth and histological grade, have been studied to predict the malignant potential of STSs (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of Minichromosome maintenance protein 7 and Geminin expression in patients with 109 soft tissue sarcomas

Hamamoto

Shomori²,

Nosaka³

et al. 2010

Oncology Letters

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Abstract. Minichromosome maintenance complex (MCM2-7)and Geminin are important in the prevention of DNA re-replication in the cell cycle, and are also prognostic markers for numerous human malignancies. The present study examined Minichromosome maintenance protein 7 (MCM7) and Geminin expression in human soft tissue sarcomas (STSs) to clarify their correlation to the clinicopathological factors. Immunohistochemistry was performed to detect the expression of MCM7, Geminin and Ki-67 on paraffin-embedded sections of 109 STSs. Labeling indices (LIs) of the molecules were evaluated in the tumors. Higher LIs of MCM7, Geminin and Ki-67 were significantly correlated with distant metastasis (P<0.01), histological grade (P<0.01) and poor prognosis (P<0.01), respectively. LIs of MCM7 and Geminin were significantly correlated with Ki-67 LIs, (MCM7/Ki-67: rs=0.745, P<0.01 and Geminin/Ki-67: rs=0.604, P<0.01). Multivariate analyses showed that the higher LIs of Geminin, but not MCM7 and Ki-67, were shown to be an independent factor of poorer prognosis (relative risk 2.72, P=0.013). The immunohistochemical expression of MCM7 and Geminin may be novel and useful markers for evaluating the prognosis in patients with human STS.

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“…Histologic grade was determined by cellularity, extent of necrosis and number of mitoses. 6,7 Two patients were in stage I, 7 in stage II and 37 in stage III. Clinical staging was determined based on the revised recommendations of the American Joint Committee on Cancer.…”

Section: Methodsmentioning

confidence: 99%

Clinical implications of serum C‐reactive protein levels in malignant fibrous histiocytoma

Nakanishi

Araki

Kudawara

et al. 2002

Intl Journal of Cancer

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Paraneoplastic syndromes (PNSs) associated with mesenchymal tumors are uncommon. Previous reports sporadically described inflammatory PNSs with elevated serum Creactive protein (CRP) levels and leukocytosis in patients with inflammatory malignant fibrous histiocytoma (MFH) of soft tissue; however, the relationship between other subtypes of MFH and PNS has not been extensively investigated. Forty-six patients with primary MFH of soft tissues who underwent radical surgery were retrospectively analyzed. These patients were divided into 2 groups according to preoperative serum CRP level: normal (<1.0 mg/dl) and elevated (>1.0 mg/dl). The correlation between serum CRP level and several clinicopathologic factors was analyzed. Correlation between preoperative serum CRP level and metastasis-free and overall survival was also investigated by univariate and multivariate analyses. Elevated preoperative serum CRP levels were found in 65% of patients with a mean of 3.7 mg/dl. There were statistically significant relationships regarding tumor size, depth, histologic subtypes, grade, stage and metastatic rate among normal and elevated CRP groups (p < 0.001, p < 0.02, p < 0.005, p < 0.001, p < 0.001 and p < 0.05, respectively). When the tumor was removed, the elevated CRP level subsided into the normal range and other abnormal laboratory findings diminished in all cases. In 11/14 relapsed cases that showed elevated CRP preoperatively, the serum CRP level re-elevated with tumor relapse. The normal CRP group showed significantly more favorable prognosis than the elevated CRP group in metastasis-free and overall survival on univariate analysis (p < 0.02, p < 0.05, respectively). Patients with MFH frequently present with an inflammatory PNS, such as elevated serum CRP level, which can be a useful marker of disease activity and a valuable prognostic indicator. © 2002 Wiley-Liss, Inc. Key words: malignant fibrous histiocytoma; paraneoplastic syndrome; C-reactive protein; tumor marker; prognosisMalignant fibrous histiocytoma (MFH) is one of the most common soft tissue sarcomas in late adult life. 1 MFH manifests variable histologic subtypes, including pleomorphic-storiform, myxoid, giant cell and inflammatory types. 2 Inflammatory MFHs have been sporadically reported to demonstrate systemic inflammatory symptoms, including fever, leukocytosis with neutrophilia or eosinophilia, accelerated erythrocyte sedimentation rate and elevated serum C-reactive protein (CRP) levels. 3,4 These paraneoplastic syndromes (PNSs) disappear after surgical resection and recur when the tumor relapses. However, such unusual manifestations have rarely been documented in other histologic subtypes of MFH. 5 In our study, the frequency of PNS in MFH was determined and serum CRP levels were evaluated continually as a representative marker of PNS. These data were then correlated with several clinicopathologic factors and prognosis.

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Histologic grading in soft‐tissue sarcomas. An analysis of 194 cases including agnor count and mast‐cell count

Cited by 39 publications

References 27 publications

A prognostic model for soft tissue sarcoma of the extremities and trunk wall based on size, vascular invasion, necrosis, and growth pattern

A prognostic model for soft tissue sarcoma of the extremities and trunk wall based on size, vascular invasion, necrosis, and growth pattern

Prognostic significance of Minichromosome maintenance protein 7 and Geminin expression in patients with 109 soft tissue sarcomas

Clinical implications of serum C‐reactive protein levels in malignant fibrous histiocytoma

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