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Nuclear morphological atypia in biopsy accurately reflects the prognosis of myxoid liposarcoma

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Abstract

Currently, it is difficult to predict the prognosis of myxoid liposarcoma (MLS) in biopsy specimens. In this study, we determined whether nuclear morphology may be used to predict the prognosis of MLS in primary biopsy specimens. Two pathologists evaluated nuclear morphology using the modified WHO/ISUP and Fuhrman grades. Survival analyses were performed by grouping nuclear high- and low-grades. We examined 53 MLS cases, which included 29 (54.7%) male and 24 (45.3%) female patients with a median age of 46 years (interquartile range, 37 − 60). In total, 7 (13.2%) and 16 (30.2%) cases were assigned to the high nuclear grade group based on the modified WHO/ISUP and Fuhrman gradings, respectively. Survival analyses revealed a significantly worse disease-free survival in the high-grade group (hazard ratio (HR), 7.51; 95% confidence interval (CI), 2.67–21.1, p < 0.001 by the modified WHO/ISUP grading; HR, 4.45; 95% CI, 1.63–12.1, p = 0.001 by the modified Fuhrman grading). Moreover, the modified WHO/ISUP grade showed a significantly worse overall survival in the high-grade group (HR, 4.39; 95% CI, 1.04–18.6, p = 0.028), and the modified Fuhrman grade exhibited a similar, but not significant, trend. Our results indicate that nuclear morphology grading is a good predictor of patient prognosis at the time of biopsy in MLS. Even when cell density is sparse, treatment strategies should be carefully considered when individual tumor cells exhibit atypical nuclei.

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Acknowledgements

The authors would like to thank Enago (www.enago.com) for the English language review.

Funding

This work was supported by the Grants-in-Aid for Scientific Research of Japan Society for the Promotion of Science (grant numbers: JP19H03444 and JP21K06887).

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Authors and Affiliations

  1. Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan

    Kengo Kawaguchi, Kenichi Kohashi, Takeshi Iwasaki, Taro Mori, Hiroshi Furukawa, Chiaki Sato, Hiroki Sonoda, Sakura Shiraishi & Yoshinao Oda

  2. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan

    Kengo Kawaguchi, Hiroshi Furukawa, Hiroki Sonoda, Sakura Shiraishi, Makoto Endo & Yasuharu Nakashima

  3. Department of Pathology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan

    Kenichi Kohashi

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  1. Kengo Kawaguchi
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Contributions

Kengo Kawaguchi, Kenichi Kohashi, and Yoshinao Oda: study concept and design; Kengo Kawaguchi, Kenichi Kohashi, Takeshi Iwasaki, Yasuharu Nakashima, and Yoshinao Oda: development of methodology and writing, review, and revision of the paper; Kengo Kawaguchi, Kenichi Kohashi, and Takeshi Iwasaki: analysis and interpretation of data and statistical analysis; Taro Mori, Hiroshi Furukawa, Chiaki Sato, Hiroki Sonoda, Sakura Shiraishi, and Makoto Endo: acquisition of data and technical and material support; Kengo Kawaguchi and Kenichi Kohashi: writing the manuscript; Kenichi Kohashi, and Yoshinao Oda: funding. All authors read and approved the final paper.

Corresponding author

Correspondence to Yoshinao Oda.

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Ethics approval

The study was approved by the Kyushu University Committee of Bioethics (approval number: 29–429).

Competing interests

Yoshinao Oda is an associate editor of Virchows Archiv. The other authors have no competing interests.

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Kawaguchi, K., Kohashi, K., Iwasaki, T. et al. Nuclear morphological atypia in biopsy accurately reflects the prognosis of myxoid liposarcoma. Virchows Arch (2024). https://doi.org/10.1007/s00428-024-03796-7

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