Towards new therapeutic strategies in chondrosarcoma Schrage, Y.M.

Schrage, Y.M.

Citation

Schrage, Y. M. (2009, November 5). Towards new therapeutic strategies in chondrosarcoma. Retrieved from https://hdl.handle.net/1887/14327

Version: Corrected Publisher’s Version

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Note: To cite this publication please use the final published version (if applicable).

and histological parameters to improve UHOLDELOLW\LQFODVVLÀFDWLRQDQGJUDGLQJRI

central cartilaginous tumours.

Daniel Eefting, Yvonne M. Schrage, Maartje J. Geirnaerdt, Saskia Le Cessie, Antonie H.M. Taminiau, Judith V.M.G. Bovée, Pancras C.W. Hogendoorn;

Eurobonet consortium.

Am J Surg Pathol 2009;33:50-7

32

Abstract

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20 enchondromas and 37 central grade I chondrosarcomas diagnosed in a PXOWLGLVFLSOLQDU\WHDPZLWKIXOOFOLQLFDOUDGLRORJLFDODQGSDWKRORJLFDOGDWD

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to differentiate enchondroma from central grade I chondrosarcoma. We GHPRQVWUDWH FRQVLGHUDEOH YDULDWLRQ LQ WKH KLVWRORJLFDO DVVHVVPHQW RI

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the diagnosis of cartilaginous tumours.

Introduction

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and peripheral chondrosarcomas are recognised, the latter developing VHFRQGDU\ WR D SUHH[LVWHQW RVWHRFKRQGURPD $OWKRXJK FHQWUDO DQG

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malignant progression in peripheral chondrosarcomas^. For the differential diagnosis central chondrosarcoma versus enchondroma these parameters DUH ODFNLQJ VWUHVVLQJ WKH QHHG RI EHWWHU GHÀQLQJ SDUDPHWHUV DW WKH OLJKW

microscopical level.

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grade I chondrosarcomas remains important.

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differential diagnosis^.

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value of individual morphologic criteria in differentiating enchondroma from central grade I chondrosarcomas and investigated their diagnostic power XVLQJDVHWRIFDVHVRIZKLFK\HDUVRIIROORZXSZDVDYDLODEOH

Materials and Methods

Cases to study interobserver variability

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FULWHULD RULJLQDOO\ GHVFULEHG E\ (YDQV HW DO^. Patient age and location of the tumour were provided, together with pre-operative radiographs, PDJQHWLFUHVRQDQFHLPDJHVRUFRPSXWHGWRPRJUDSK\VFDQV2QHWXPRXU

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  Distal femur

Table 2.1 Patients to study interobserver variability. Information as provided to the pathologists.

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Cases to study histological criteria

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detailed follow-up including adequate radiological follow-up documentation.

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a protracted clinical course with almost no metastases despite ominous KLVWRORJ\^&OLQLFDOGHWDLOVDUHJLYHQLQWDEOH7ZRFDVHVZHUHH[FOXGHG

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Histopathology

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the resected specimen as discussed in the aforementioned panel was used DVFRQÀUPDWLRQ

Statistical Analysis Interobserver variability

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Figure 2.1 Light-micrographs displaying the morphologic parameters shown to be of di- agnostic value$3UHVHQFHRIKRVWERQHHQWUDSPHQWPDJQLÀFDWLRQ[%2SHQFKURPDWLQ

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Histological criteria

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values for enchondroma or low-grade chondrosarcoma were computed for different diagnostic parameters. The Chi-square test was used to compare SHUFHQWDJHVEHWZHHQWKHWZRJURXSV$SYDOXHOHVVWKDQRUHTXDOWR

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enchondroma from central grade I chondrosarcoma.

Results

Assessment of interobserver variability

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Assessment of histological criteria to distinguish enchondroma vs grade I chondrosarcoma

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Table 2.4. Morphologic matrix quality of enchondromas and chondrosarcomas.

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chondrosarcomas.



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up Total

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the actual histological evaluation*

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Chondrosarcomas 2 33 35

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Table 2.5. Histopathological assessment compared with the consensus diagnosis after ten years of follow-up. 7KLVGLDJQRVLVZDVPDGHRQO\DZDUHRIWKHORFDOLVDWLRQRIWKHWXPRXU

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Discussion

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that the diagnosis and histological grading of cartilaginous tumours is FKDOOHQJLQJ7KLVLVLQFRQFRUGDQFHZLWKWKHUHVXOWVRIWKH$PHULFDQ6/,&('

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cartilaginous tumours were advocated in the past^, although the GLDJQRVWLFYDOXHRILQGLYLGXDOPRUSKRORJLFFULWHULDRUKRZWKH\DUHKDQGOHG

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pathologic features^.

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an enchondroma.

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instead of histological grading as a measurement for outcome in molecular studies searching for prognostic parameters of chondrosarcoma.

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chondrosarcoma, the distinction with grade II chondrosarcoma is essential



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grounds alone^. Therefore, when the radiological assessment of a EHQLJQYHUVXVDORZJUDGHPDOLJQDQWFHQWUDOFDUWLODJLQRXVWXPRXUUHPDLQV

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Acknowledgements

The authors like to thank the specialised panellists that participated in the LQWHUREVHUYHUYDULDELOLW\VWXG\7$LJQHU1$WKDQDVRX)%HUWRQL

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grade I chondrosarcoma. A J R

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