title: [Place of the pathologist in the management of primary bone tumors (osteosarcoma and Ewing's family tumors after neoadjuvant treatment)].
abstract: The survival of osteosarcoma and Ewing family tumours has been improved by the introduction of neoadjuvant chemotherapy. The response to preoperative chemotherapy is evaluated on the microscopic analysis of the surgical resection, by the percentage of tumour necrosis according to the Huvos and Rosen's grading. It remains the only reliable prognostic factor for patients and is used to guide the choice of post-operative chemotherapy. The macroscopic and microscopic management of the surgical resection (cf. supra) is essential and is the subject of a specific protocol. Several studies have been conducted to identify news factors able to predict the response to chemotherapy, the tumour aggressiveness and its ability to develop metastases. Inhibitors of mTOR and/or regulators of the balance RANKL/OPG are promising therapeutics. The study's expression of these new factors could be performed on the biopsy and will offer new therapeutic strategy.
authors.affiliation: Service de pathologie, département d'anatomie et cytologie pathologiques, Toulouse, France. brouchet.anne@chu-toulouse.fr
authors.forename: Anne
authors.initials: A
authors.lastname: Gomez-Brouchet
authors.forename: Corinne
authors.initials: C
authors.lastname: Bouvier
authors.forename: Anne-Valérie
authors.initials: AV
authors.lastname: Decouvelaere
authors.forename: Frédérique
authors.initials: F
authors.lastname: Larousserie
authors.forename: Sébastien
authors.initials: S
authors.lastname: Aubert
authors.forename: Xavier
authors.initials: X
authors.lastname: Leroy
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Guinebretière
authors.forename: Aurore
authors.initials: A
authors.lastname: Coulomb
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Cassagnau
authors.forename: Anne
authors.initials: A
authors.lastname: de Muret
authors.forename: Virginie
authors.initials: V
authors.lastname: Audard
authors.forename: Béatrice
authors.initials: B
authors.lastname: Marie
authors.forename: Gonzague
authors.initials: G
authors.lastname: de Pinieux
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D001859:Bone Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D019468:Disease Management; D006801:Humans; D033183:Interdisciplinary Communication; D008279:Magnetic Resonance Imaging; D058990:Molecular Targeted Therapy; D020360:Neoadjuvant Therapy; D012516:Osteosarcoma / Q000737:chemistry / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D010338:Pathology, Clinical; D010819:Physician's Role; D011379:Prognosis; D012512:Sarcoma, Ewing / Q000737:chemistry / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D013048:Specimen Handling / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor