1 / 17

Prognostic value of myogenic differentiation in adult soft tissue sarcomas (STS) A study of 855 cases from the French S

Prognostic value of myogenic differentiation in adult soft tissue sarcomas (STS) A study of 855 cases from the French Sarcoma Group. N Stock, MC Chateau, F Collin, L Guillou, A Leroux, B Marques, JJ Michels, D Ranchere, YM Robin, P Terrier, M Trassard, I Valo and JM Coindre.

delu
Download Presentation

Prognostic value of myogenic differentiation in adult soft tissue sarcomas (STS) A study of 855 cases from the French S

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Prognostic value of myogenic differentiation in adult soft tissue sarcomas (STS)A study of 855 cases from the French Sarcoma Group N Stock, MC Chateau, F Collin, L Guillou, A Leroux, B Marques, JJ Michels, D Ranchere, YM Robin, P Terrier, M Trassard, I Valo and JM Coindre Department of Pathology, Institut Bergonié, Bordeaux, France and Pathology subgroup, French Sarcoma Group, France

  2. Genetic classificationof STS • Sarcomas with recurrent translocations • Sarcomas with oncogenic mutations • Sarcomas with simple genetic profile • Sarcomas with complex genetic profile

  3. Sarcomas with complex genetic profile • Leiomyosarcomas • Adult rhabdomyosarcomas • Pleomorphic liposarcomas • Myxofibrosarcomas • Poorly-differentiated sarcomas / MFH

  4. Sarcomas with complex genetic profile • Spindle cell / pleomorphic sarcomas • Difficult to classify • Prognosis and myogenic differentiation • Fletcher et al. J Clin Oncol 2001;19:3045-50 • Deyrup et al. Cancer 2003;98:805-13

  5. French Sarcoma Group Database • 2538 adult STS with primary event (January 2006) • STS with translocations: 785 (27.2%) • ALT/WDLPS and dedifferentiated LPS: 355 (12.3%) • MPNST, angioS, chondroS, osteoS,..: 401 (13.9%) • LMS, adult RMS, pleomorphic LPS, MFS and poorly-diff sarcomas/MFH: 1348 ( 46.7%)

  6. French Sarcoma Group DatabaseSarcomas with complex genetic profile • LMS, adult RMS, pleomorphic LPS, MFS and poorly-diff sarcomas/MFH: 1348 • 1002 with paraffin block directly available (biopsy and/or surgery in FSG centers) • 276 cases with frozen tissue for CGH-array and cDNA

  7. Sarcomas with complex genetic profileRe-classification - Methods • Pathology review (1002) • IHC on whole tissue sections (520):SMA, desmin, caldesmon, myogenin… • IHC on TMA (482):muscular markers, keratin, S100, CD34, MDM2, CDK4,…. • Fletcher et al, J Clin Oncol 2001;19:3045-50

  8. Sarcomas with complex genetic profileRe-classification - Results • 1002 cases: • 928 complex genetic profile sarcomas • 74 reclassified: 27 DDLPS, 47 others • 73 with metastasis at time of diagnosis and thus excluded for metastasis free survival study.

  9. Sarcomas with complex genetic profileRe-classification - Results Initial diagnosis (855) • LMS: 279 (32.6%) • Adult RMS: 23 • Pleomorphic LPS: 50 • MyxoFS: 32 (3.7%) • MFH: 471 (55%) • Final diagnosis (855) • LMS: 355 (41.5%) • Adult RMS: 28 • Pleomorphic LPS: 50 • MyxoFS: 128 (15%) • MFH: 294 (34.4%)

  10. Sarcomas with complex genetic profilePatients • Median age: 62 (15 - 98) • Sex: 447 M / 408 F • Locations: extremities 601 (70.3%), trunk wall 159 (18.6%), internal trunk 69 (8.1%), head and neck 26 (3%) • Deep tumors: 716 (83.7%) • Median size: 8 cm (1 - 30) • Median FU: 102 months • Distant metastasis: 296 (34.6%)

  11. Sarcomas with complex genetic profilePredictive factors for metastasis Univariate analysis • Grade: 3.1x10-8 • Myogenic differentiation: 4.7x10-7 • Internal trunk location: 1.4x10-4 • Tumor depth: 2.7x10-9 • Tumor size: 4.4x10-7

  12. Metastasis-free survival MyxoFS (n=128) MFH (n=294) LeiomyoS (n=355) P = 6.4 x 10-6

  13. Metastasis-free survival Myogenic differentiation Non-myogenic sarcomas (n=472) probability Myogenic sarcomas (n=383) P = 4.3 x 10-7 Time in months

  14. Metastasis-free survival Degree of differentiation MFH (n=294) Poorly D LeiomyoS (n=182) Well D LeiomyoS (n=172) P = 0.002

  15. Sarcomas with complex genetic profilePredictive factors for metastasis Multivariate analysis 1- Histological grade: x 4.65 2- Tumor depth: x 2.91 3- Myogenic differentiation: x 1.56 4- Internal trunk location: x1.52

  16. Complex genetic profile sarcomas excluding internal trunk n=626 Predictive factors for metastasis • Univariate analysis • Grade: 3.2x10-5 • Myogenic differentiation: 1.6x10-5 • Tumor size: 0.03 • Multivariate analysis • Histological grade: x 3.3 • Myogenic differentiation: x 1.44

  17. Sarcomas with complex genetic profileConclusions • Myogenic differentiation is an adverse prognostic factor • About 30% of sarcomas with complex genetic profiles are poorly differentiated and difficult to classify • Studies of genetic alterations should provide help for a more reproducible classification

More Related