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J Clin Pathol 2003;56:831-834 doi:10.1136/jcp.56.11.831
  • Original article

Prognostic relevance of rosette-like features in osteosarcoma

  1. K Okada1,
  2. T Hasegawa2,
  3. R Yokoyama3,
  4. Y Beppu3,
  5. E Itoi1
  1. 1Department of Orthopaedic Surgery, Akita University School of Medicine, Akita 010-8543, Japan
  2. 2Pathology Division, National Cancer Centre Research Institute, Tokyo 104-0045, Japan
  3. 3Orthopaedic Divisions, National Cancer Centre Research Institute and Hospital, Tokyo 104-0045, Japan
  1. Correspondence to:
 Dr K Okada
 MD, Department of Orthopaedic Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; cshokadamed.akita-u.ac.jp
  • Accepted 7 April 2003

Abstract

Aims: To clarify the prognostic relevance of rosette-like features and other clinicopathological and immunohistochemical variables in patients with osteosarcoma.

Methods: Clinicopathological and immunohistochemical variables were analysed in 131 patients with non-metastatic high grade conventional osteosarcoma, with particular attention to the prognostic impact of rosette-like features.

Results: Rosette-like features were present in 18 (14%) cases. Rosette-like features were significantly associated with the osteoblastic subtype, numerous osteoclast-like giant cells, moderate pleomorphism, frequent haemangiopericytoma-like vascular patterns, epithelioid cytological features, positive immunoreactivity for epithelial membrane antigen and CD56, and negative staining for cytokeratin. In a multivariate analysis, rosette-like features (relative risk (RR), 3.8), a poor chemotherapy effect (RR, 2.9), and a tumour size of 10 cm or more (RR, 2.8) were identified as unfavourable prognostic factors.

Conclusions: Rosette-like features can easily be identified from routine histological slides and the relative risk in patients with non-metastatic, conventional osteosarcoma is as high as other well known prognostic factors, including large size and poor chemotherapy effect.

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