Virchows Archiv A

, Volume 409, Issue 5, pp 627–640 | Cite as

Histopathological predictive factors in Ewing's sarcoma of bone and clinicopathological correlations

A retrospective study of 261 cases
  • A. Llombart-Bosch
  • G. Contesso
  • M. Henry-Amar
  • M. J. Lacombe
  • O. Oberlin
  • J. Dubousset
  • J. Rouëssé
  • D. Sarrazin
Article

Summary

A retrospective multifactorial analysis on 261 previously untreated patients with Ewing's sarcoma (Es) of bone has been carried out in order to ascertain the prognostic value of several histological variables on survival. Among those cases accepted as Es, 208 (80% of the patients) were considered to be “typical Es”, while 40 (15%) displayed a large cell predominance, being subclassified as “atypical large cell Es”. Furthermore, 13 patients (5%) possessed tumours of endothelial-like appearance. Eleven cases which displayed a mixed histological configuration were finally included within one of the three previous groups according to their predominant histological pattern.

After adjustment for therapeutic regimens and initial location of the tumour, only two histological characteristics remain significant; i.e. the presence of necrosis (p=0.002) and, to a lesser degree, the presence of filagree “en damier” pattern (p=0.08), both of which are of poor prognostic value. From this study, it can be assumed that the morphological (and possibly histogenetical) heterogeneity of Es of bone has no prognostic influence on survival.

Key words

Ewing's sarcoma Bone Histology Prognosis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Apel R, Delling G, Krumme H, Winkler K, Salzer-Kuntschik M (1985) Nuclear polymorphism in osteosarcoma as a prognostic factor for the effect of chemotherapy. A quantitative study. Virchows Arch (Pathol Anat) 405:215–223Google Scholar
  2. Askin FB, Rosai J, Sibley RK, Dehner LP, McAlister WH (1979) Malignant small cell tumor of the thoracopulmonary region of childhood. A distinctive clinicopathologic entity of uncertain histogenesis. Cancer 43:2438–2451Google Scholar
  3. Breslow N (1979) Statistical methods for censored survival data. Environ Health Perspect 32:181–192Google Scholar
  4. Costa J, Wesley RA, Glatstein E, Rosenberg SA (1984) The grading of soft-tissue sarcomas: Results of a clinico-histopathological correlation in a series of 163 cases. Cancer 53:530–538Google Scholar
  5. Cox DR (1972) Regression model and life-tables. J R Stat Soc 33:187–220Google Scholar
  6. Deméocq F, Carton P, Patte C, Oberlin O, Sarrazin D, Lemerle J (1984a) Traitement du sarcome d'Ewing par chimiothérapie initiale intensive. Premier bilan d'un protocole multicentrique français. Presse Méd 13:717–721Google Scholar
  7. Deméocq F, Oberlin O, Brunat-Mentigny M, Carton P, Lacombe MJ, Olive D, Patte C, Sarrazin D, Tron P, Lemerle J (1984b) Primary chemotherapy and tumor resection in Ewing's sarcoma of the ribs. Report of the French Society of Paediatric Oncology. Eur Paediatr Haematol Oncol 1:245–250Google Scholar
  8. Dixon WJ, Brown MB, Engelman L, Franc JW, Hill MA, Jennrich RI, Toporek JD (1981) BMDP statistical software. University of California Press, Berkeley, CaliforniaGoogle Scholar
  9. Glaubiger DL, Makuch R, Schwarz J, Levine As, Johnson RE (1980) Determination of prognostic factors and their influence on therapeutic results in patients with Ewing's sarcoma. Cancer 45:2213–2219Google Scholar
  10. Gonzales-Crussi F, Wolfson SL, Migusi K, Nakajima T (1984) Peripheral neuroectodermal tumors of the chest wall in childhood. Cancer 54:2519–2527Google Scholar
  11. Jaffe R, Santamaria M, Yunis EJ, Tannery NH, Agostini RM, Medina J, Goodman M (1984) The neuroectodermal tumor of bone. Am J Surg Pathol 8:885–898Google Scholar
  12. Johnson RE, Pomeroy TC (1975) Prognostic factors for survival in Ewing's sarcoma. Am J Roentgenol Radium Ther Nucl Med 123:583–587Google Scholar
  13. Kinsella TJ, Lichter AS, Miser GS, Gerber L, Glatstein E (1984) Local treatment of Ewing's sarcoma: Radiation therapy versus surgery. Cancer Treat Rep 68:695–702Google Scholar
  14. Kissane JM, Askin FB, Foulkes M, Stratton LB, Shirley SF (1983) Ewing's sarcoma of bone: Clinico-pathological aspects of 303 cases from the Intergroup Ewing's Sarcoma Study. Hum Pathol 14:773–779Google Scholar
  15. Llombart-Bosch A, Blaché R, Peydro-Olaya A (1978) Ultrastructural study of 28 cases of Ewing's sarcoma. Typical and atypical forms. Cancer 41:1362–1373Google Scholar
  16. Llombart-Bosch A, Peydro-Olaya A, Gomar F (1980) Ultrastructure of one Ewing's sarcoma of bone with endothelial character and a comparative review of the vessels in 27 cases of typical Ewing's sarcoma. Pathol Res Pract 167:71–87Google Scholar
  17. Llombart-Bosch A, Blaché R, Peydro-Olaya A (1982) Round cell sarcomas of bone and their differential diagnosis (with particular emphasis on Ewing's sarcoma and reticulosarcoma). A study of 233 tumours with optical and electron microscopical techniques. Pathol Ann 17 (pt 2):113–145Google Scholar
  18. Llombart-Bosch A (1983) Ewing's sarcoma of bone. A unique tumoral entity? Guest lecture. IXth European Congress of Pathology, Hamburg (19–23 Sept)Google Scholar
  19. Martin SE, Dwyer A, Kissane JM, Costa J (1982) Small cell osteosarcoma. Cancer 50:990–996Google Scholar
  20. Mendenhall CM, Marcus RB, Enneking WF, Springfield DS, Thar TL, Millon R (1983) The prognostic significance of soft-tissue extension in Ewing's sarcoma. Cancer 51:913–917Google Scholar
  21. Miser J, Steis R, Longo DL, Belasco JB, Triche T, Kinsella TJ (1985) Treatment of newly diagnosed high-risk sarcomas and primitive neuroectodermal tumors (TNET) in children and young adults. Proc Am Soc Clin Oncol 4:240 (C-935)Google Scholar
  22. Nascimento AG, Uni KK, Pritchard DJ, Cooper KL, Dahlin DC (1980) A clinico-pathological study of 20 cases of large cell (atypical) Ewing's sarcoma of bone. Am J Surg Pathol 4:29–36Google Scholar
  23. Nesbit ME, Perez CA, Tefft M, Burgert EOI Vietti TJ, Kissane J, Pritchard DJ, Gehan EA (1981) Multimodal therapy for the management of primary non-metastatic Ewing's sarcoma of bone: An intergroup study. Natl Cancer Inst Monogr 56:255–262Google Scholar
  24. Oberlin O, Patte C, Deméocq F, Lacombe MJ, Brunat-Mentigny M, Demaille MC, Tron P, N'guyen Bui, Lemerle J (1985) The response to initial chemotherapy as a prognostic factor in localized Ewing's sarcoma. Eur J Cancer Clin Oncol 21:463–467Google Scholar
  25. Perez CA, Razek A, Tefft M, Nesbit ME, Burgert EO, Kissane J, Vietti T, Gehan EA (1977) Analysis of local tumor control in Ewing's sarcoma: Preliminary results of a Cooperative Intergroup Study. Cancer 40:2864–2873Google Scholar
  26. Pilepich MV, Vietti TG, Nesbit ME, Tefft M, Kissane J, Burgert EO, Pritchard D, Gehan EA (1981) Ewing's sarcoma of the vertebral column. Int J Radiat Oncol Biol Phys 7:27–31Google Scholar
  27. Pomeroy TC, Johnson RE (1975) Combined modality therapy of Ewing's sarcoma. Cancer 35:36–47Google Scholar
  28. Pritchard DJ, Dahlin DC, Dauphine RT, Taylor WF, Beabout JW (1975) Ewing's sarcoma: A clinico-pathological and statistical analysis of patients surviving five years or longer. J Bone Joint Surg (Ann) 57:10–16Google Scholar
  29. Rosen G, Caparros B, Mosende C, McCormick B, Huvos AG, Marcove R (1978) Curability of Ewing's sarcoma and considerations for future therapeutical trials. Cancer 41:888–889Google Scholar
  30. Rosen G, Caparros B, Niremberg A, Marcove RC, Huvos AG, Kosloff C, Lane JM, Murphy M (1981) Ewing's sarcoma; ten years' experience with adjuvant chemotherapy. Cancer 47:2204–2213Google Scholar
  31. Stefani E, Carzoglio M, Pellegrini HD, Olivera L, Cendan M, Kasdorf H (1984) Ewing's sarcoma: value of tumor necrosis as a predictive factor. Bull Cancer (Paris) 71:16–21Google Scholar
  32. Thomas PR, Foulkes MA, Gilula LA, Burgert EO, Evans RG, Kissane J, Nesbit ME, Pritchard DJ, Tefft M, Vietti TJ (1983) Primary Ewing's sarcoma of the ribs: A report from the Intergroup Ewing's Sarcoma Study. Cancer 51:1021–1027Google Scholar
  33. Triche TJ, Ross WJ (1978) Glycogen-containing neuroblastoma with clinical and histopathological features in Ewing's sarcoma. Cancer 41:1425–1432Google Scholar
  34. Triche TJ, Askin FB (1983) Neuroblastoma and the differential diagnosis of small round blue cell tumors. Hum Pathol 14:569–595Google Scholar
  35. Trojani M, Contesso G, Coindre JM, Rouëssé J, Bui NB, Demascarell A, Goussot JF, David F, Bonichon F, Lagarde C (1984) Soft-tissue sarcomas of adults: Study of pathological prognostic variables and definition of a histopathological grading system. Int J Cancer 33:37–42Google Scholar
  36. Wartelle M, Kramar A, Jan P, Kruger D (1983) “PIGAS”: an interactive statistical database management system. In: Proceedings of the Second International Workshop on Statistical Database Management, Los Altos, CaliforniaGoogle Scholar
  37. Zucker JM, Henry-Amar M (1977) Therapeutic controlled trial in Ewing's sarcoma. Report on the results of a trial by the Clinical Cooperative Group on Radio- and Chemotherapy of the E.O.R.T.C. Eur J Cancer 13:1019–1023Google Scholar
  38. Zucker JM, Henry-Amar M, Sarrazin D, Blaché R, Patte C, Schweisguth O (1983) Intensive systemic chemotherapy in localized Ewing's sarcoma in childhood. A historical trial. Cancer 52:415–423Google Scholar

Copyright information

© Springer-Verlag 1986

Authors and Affiliations

  • A. Llombart-Bosch
    • 1
  • G. Contesso
    • 2
  • M. Henry-Amar
    • 3
  • M. J. Lacombe
    • 2
  • O. Oberlin
    • 4
  • J. Dubousset
    • 5
  • J. Rouëssé
    • 6
  • D. Sarrazin
    • 7
  1. 1.Department of PathologyMedical School of ValenciaSpain
  2. 2.Department of PathologyHospital St Vincent de PaulParisFrance
  3. 3.Department of Medical StatisticsHospital St Vincent de PaulParisFrance
  4. 4.Department of PaediatricsHospital St Vincent de PaulParisFrance
  5. 5.Department of SurgeryHospital St Vincent de PaulParisFrance
  6. 6.Department of Medicine BInstitut Gustave RoussyVillejuifFrance
  7. 7.Department of RadiotherapyInstitut Gustave RoussyVillejuifFranceFrance

Personalised recommendations