Dedifferentiation in bone and soft tissue sarcomas: How do we define it? What is prognostically relevant?

被引:3
|
作者
Dry, Sarah M. [1 ]
机构
[1] UCLA David Geffen Sch Med, Dept Pathol & Lab Med, 13-222 CHS,10833 Le Conte Ave, Los Angeles, CA 90095 USA
关键词
Dedifferentiation; Chondrosarcoma; Liposarcoma; Chordoma; Parosteal osteosarcoma; Evidence-based; Diagnostic criteria; Grading; WELL-DIFFERENTIATED LIPOSARCOMA; PAROSTEAL OSTEOSARCOMA; CLINICOPATHOLOGICAL ANALYSIS; INTEROBSERVER VARIABILITY; CARTILAGINOUS TUMORS; CHONDROSARCOMA; GRADE; CHORDOMA; DIAGNOSIS; RELIABILITY;
D O I
10.1016/j.humpath.2024.02.001
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Dedifferentiation traditionally is defined by descriptive criteria as a tumor showing an abrupt change in histology from a conventional, classic, low-grade appearing neoplasm to a tumor that is more cellular, pleomorphic and "high grade", with grading typically being performed by subjective criteria. The dedifferentiated areas range from areas with recognizable histologic differentiation which differs from the primary tumor (such as an osteosarcoma arising from a low-grade chondrosarcoma) to areas containing sarcomas without specific histologic differentiation (such as pleomorphic or spindle cell sarcoma). Many, but not all, dedifferentiated tumors are aggressive and associated with significantly shorter survival than their conventional counterparts, even grade 3 conventional tumors. As a result, dedifferentiated tumors are generally considered to be clinically aggressive and as a result, more aggressive surgery or the addition of (neo)adjuvant chemotherapy is often considered. However, long-term (greater than 20 year) survivors are reported in the most common dedifferentiated bone and soft tissue sarcomas. Moreover, use of mitotic criterion for defining dedifferentiation in dedifferentiated liposarcoma as well as grading (by the French system) have been found to be associated with survival. This paper reviews the literature on dedifferentiated chondrosarcoma, dedifferentiated liposarcoma, dedifferentiated chordoma and dedifferentiated parosteal osteosarcoma. As a result of that review, recommendations are advocated to identify evidence-based, objective diagnostic and grading criteria for dedifferentiation that are appropriate for each tumor type. Adding such criteria will improve consistency in diagnosis worldwide, allow easier comparison of clinical research performed on dedifferentiated tumors and help communicate (to patients and clinicians) the tumors with highest risk of clinically aggressive behavior, to allow appropriate and personalized treatment planning.
引用
收藏
页码:139 / 147
页数:9
相关论文
共 50 条
  • [31] Local Control of Soft Tissue and Bone Sarcomas
    Crompton, Joseph G.
    Ogura, Koichi
    Bernthal, Nicholas M.
    Kawai, Akira
    Eilber, Fritz C.
    JOURNAL OF CLINICAL ONCOLOGY, 2018, 36 (02) : 111 - +
  • [32] RADIOLOGY OF BONE AND SOFT-TISSUE SARCOMAS
    FORRESTER, DM
    BECKER, TS
    ORTHOPEDIC CLINICS OF NORTH AMERICA, 1977, 8 (04) : 973 - 998
  • [33] Radiologic Approach to Bone and Soft Tissue Sarcomas
    Caracciolo, Jamie T.
    Letson, G. Douglas
    SURGICAL CLINICS OF NORTH AMERICA, 2016, 96 (05) : 963 - +
  • [34] BONE AND SOFT-TISSUE SARCOMAS - AN OVERVIEW
    MAREE, D
    ROUESSE, J
    BULLETIN DU CANCER, 1988, 75 (05) : 409 - 415
  • [35] Pediatric bone and soft-tissue sarcomas
    Beth McCarville
    Cancer Imaging, 15 (Suppl 1)
  • [36] EPIDEMIOLOGY OF BONE AND SOFT-TISSUE SARCOMAS
    MCCLAY, EF
    SEMINARS IN ONCOLOGY, 1989, 16 (04) : 264 - 272
  • [37] Staging of Bone and Soft-tissue Sarcomas
    Steffner, Robert J.
    Jang, Eugene S.
    JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS, 2018, 26 (13) : E269 - E278
  • [38] Soft tissue and bone sarcomas in association with pregnancy
    Merimsky, O
    La Cesne, A
    ACTA ONCOLOGICA, 1998, 37 (7-8) : 721 - 727
  • [39] The management of bone and soft tissue sarcomas - Preface
    Choong, PFM
    ACTA ORTHOPAEDICA SCANDINAVICA, 1997, 68 : 1 - 3
  • [40] TREATMENT OF BONE AND SOFT-TISSUE SARCOMAS
    ROUESSE, J
    TUBIANAHULIN, M
    PRESSE MEDICALE, 1991, 20 (27): : 1249 - 1251