Prognostic relevance of rosette-like features in osteosarcoma.
OBJECTIVE
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.
Department of Orthopaedic Surgery, Akita University School of Medicine, Akita 010-8543, Japan. cshokada@med.akita-u.ac.jp
K
K
Okada
T
T
Hasegawa
R
R
Yokoyama
Y
Y
Beppu
E
E
Itoi
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D015999:Multivariate Analysis; D012516:Osteosarcoma / Q000188:drug therapy / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome