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Prognostic value of proliferation in pleomorphic soft tissue sarcomas: a new look at an old measure.

Seinen, Jojanneke M; Jönsson, Mats LU ; Bendahl, Pär-Ola LU ; Baldetorp, Bo LU ; Rambech, Eva LU ; Åkerman, Måns; Rydholm, Anders LU ; Nilbert, Mef LU and Carneiro, Ana LU (2012) In Human Pathology
Abstract
Though proliferation has repeatedly shown a prognostic role in sarcomas, it has not reached clinical application. We performed a comprehensive evaluation of the prognostic role of 5 proliferation measures in a large series of soft tissue sarcomas of the extremities and the trunk wall. One hundred ninety-six primary soft tissue sarcomas of the extremities and the trunk wall were subjected to DNA flow cytometry for quantification of S-phase fraction and to immunohistochemical evaluation of Ki-67, Top2a, p21, and p27Kip1. In univariate analysis, positive expression of Ki-67 (hazard ratio = 4.5, CI = 1.6-12.1), Top2a (hazard ratio = 2.2, CI = 1.2-3.5) and high S-phase fraction (hazard ratio = 1.8, CI = 1.2-3.7) significantly correlated with... (More)
Though proliferation has repeatedly shown a prognostic role in sarcomas, it has not reached clinical application. We performed a comprehensive evaluation of the prognostic role of 5 proliferation measures in a large series of soft tissue sarcomas of the extremities and the trunk wall. One hundred ninety-six primary soft tissue sarcomas of the extremities and the trunk wall were subjected to DNA flow cytometry for quantification of S-phase fraction and to immunohistochemical evaluation of Ki-67, Top2a, p21, and p27Kip1. In univariate analysis, positive expression of Ki-67 (hazard ratio = 4.5, CI = 1.6-12.1), Top2a (hazard ratio = 2.2, CI = 1.2-3.5) and high S-phase fraction (hazard ratio = 1.8, CI = 1.2-3.7) significantly correlated with risk for metastasis. When combined with currently used prognostic factors, Ki-67, S-phase fraction and Top2a fraction contributed to refined identification of prognostic risk groups. Proliferation, as assessed by expression of Ki-67 and Top2a and evaluation of S-phase fraction and applied to statistical decision-tree models, provides prognostic information in soft tissue sarcomas of the extremity and trunk wall. Though proliferation contributes independently to currently applied prognosticators, its role is particularly strong when few other factors are available, which suggests a role in preoperative decision-making related to identification of high-risk individuals who would benefit from neoadjuvant therapy. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
Human Pathology
publisher
Elsevier
external identifiers
  • wos:000311762500018
  • pmid:22789784
  • scopus:84869498487
ISSN
1532-8392
DOI
10.1016/j.humpath.2012.03.022
language
English
LU publication?
yes
id
e3bd01b4-0b77-4cdc-83ce-e117af7c5ff2 (old id 2967193)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22789784?dopt=Abstract
date added to LUP
2012-08-09 18:54:24
date last changed
2017-01-01 07:39:05
@article{e3bd01b4-0b77-4cdc-83ce-e117af7c5ff2,
  abstract     = {Though proliferation has repeatedly shown a prognostic role in sarcomas, it has not reached clinical application. We performed a comprehensive evaluation of the prognostic role of 5 proliferation measures in a large series of soft tissue sarcomas of the extremities and the trunk wall. One hundred ninety-six primary soft tissue sarcomas of the extremities and the trunk wall were subjected to DNA flow cytometry for quantification of S-phase fraction and to immunohistochemical evaluation of Ki-67, Top2a, p21, and p27Kip1. In univariate analysis, positive expression of Ki-67 (hazard ratio = 4.5, CI = 1.6-12.1), Top2a (hazard ratio = 2.2, CI = 1.2-3.5) and high S-phase fraction (hazard ratio = 1.8, CI = 1.2-3.7) significantly correlated with risk for metastasis. When combined with currently used prognostic factors, Ki-67, S-phase fraction and Top2a fraction contributed to refined identification of prognostic risk groups. Proliferation, as assessed by expression of Ki-67 and Top2a and evaluation of S-phase fraction and applied to statistical decision-tree models, provides prognostic information in soft tissue sarcomas of the extremity and trunk wall. Though proliferation contributes independently to currently applied prognosticators, its role is particularly strong when few other factors are available, which suggests a role in preoperative decision-making related to identification of high-risk individuals who would benefit from neoadjuvant therapy.},
  author       = {Seinen, Jojanneke M and Jönsson, Mats and Bendahl, Pär-Ola and Baldetorp, Bo and Rambech, Eva and Åkerman, Måns and Rydholm, Anders and Nilbert, Mef and Carneiro, Ana},
  issn         = {1532-8392},
  language     = {eng},
  month        = {07},
  publisher    = {Elsevier},
  series       = {Human Pathology},
  title        = {Prognostic value of proliferation in pleomorphic soft tissue sarcomas: a new look at an old measure.},
  url          = {http://dx.doi.org/10.1016/j.humpath.2012.03.022},
  year         = {2012},
}