Prognostic significance of histologic grade and nuclear expression of beta-catenin in synovial sarcoma

Citation
T. Hasegawa et al., Prognostic significance of histologic grade and nuclear expression of beta-catenin in synovial sarcoma, HUMAN PATH, 32(3), 2001, pp. 257-263
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Research/Laboratory Medicine & Medical Tecnology","Medical Research Diagnosis & Treatment
Journal title
HUMAN PATHOLOGY
ISSN journal
0046-8177 → ACNP
Volume
32
Issue
3
Year of publication
2001
Pages
257 - 263
Database
ISI
SICI code
0046-8177(200103)32:3<257:PSOHGA>2.0.ZU;2-4
Abstract
Synovial sarcoma, which has a wide spectrum of biologic behavior, warrants accurate grading to assess the patient's prognosis. We studied the clinicop athologic and immunohistochemical features of 44 cases of synovial sarcoma in patients treated primarily or secondarily at the National Cancer Center, Tokyo, to identify independent prognostic factors. There were local recurr ences in 16 patients (36%), and 25 (57%) developed metastases, primarily to the lungs, The estimated cumulative 5-year and 10-year survival rates were 68% and 41%, respectively. Variables associated with an adverse outcome in cluded tumor size >6.7 cm; initial treatment outside the National Cancer Ce nter; poorly differentiated subtype; high nuclear atypia; mitosis count >27 /10 high-power fields; tumor necrosis; absence of stromal calcification; nu clear expression of beta -catenin, which was found in 25 cases (57%); Ki-67 (MIB-1) index >27%; and histologic grade 3. Nuclear accumulation of beta - catenin as a cell-signaling event may play an important role in the progres sion of synovial sarcoma and therefore might be predictive of short surviva l. However, multivariate analysis clearly showed that only histologic grade , as defined by using categorized variables for the MIB-1 index and tumor n ecrosis, was an independent prognostic factor. Most variables were correlat ed with lung metastasis and histologic grade. High-grade synovial sarcoma a ssessed by a histologic grading system based on the proliferative activity of the neoplastic cells can be viewed as high risk with the patients most l ikely to die of disease within 10 years after surgery and in need of improv ed chemotherapy. HUM PATHOL 32:257-263, Copyright (C) 2001 by W.B. Saunders Company.