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Myoid differentiation and prognosis in adult pleomorphic sarcomas of the extremity

An analysis of 92 cases

  1. Andrea T. Deyrup M.D., Ph.D.1,
  2. Rex C. Haydon M.D., Ph.D.2,
  3. Dezheng Huo M.D., M.S.3,
  4. Akira Ishikawa M.D., Ph.D.2,4,
  5. Terrance D. Peabody M.D.2,
  6. Tong-Chuan He M.D., Ph.D.2,
  7. Anthony G. Montag M.D.1,4,†,*

Article first published online: 16 JUL 2003

DOI: 10.1002/cncr.11617

Issue

Cancer

Cancer

Volume 98, Issue 4, pages 805–813, 15 August 2003

Additional Information

How to Cite

Deyrup, A. T., Haydon, R. C., Huo, D., Ishikawa, A., Peabody, T. D., He, T.-C. and Montag, A. G. (2003), Myoid differentiation and prognosis in adult pleomorphic sarcomas of the extremity. Cancer, 98: 805–813. doi: 10.1002/cncr.11617

Author Information

  1. 1

    Department of Pathology, The University of Chicago Medical Center, Chicago, Illinois

  2. 2

    Molecular Oncology Laboratory, Department of Surgery, The University of Chicago Medical Center, Chicago, Illinois

  3. 3

    Department of Health Studies, The University of Chicago, Chicago, Illinois

  4. 4

    Department of Orthopaedic Surgery, Yamagata University School of Medicine, Yamagata, Japan

  1. †

    Fax: (773) 702-9903

*Department of Pathology, The University of Chicago Medical Center, 5841 South Maryland Avenue, MC 6101, Chicago, IL 60637

Publication History

  1. Issue published online: 1 AUG 2003
  2. Article first published online: 16 JUL 2003
  3. Manuscript Accepted: 30 MAY 2003
  4. Manuscript Revised: 14 MAY 2003
  5. Manuscript Received: 26 FEB 2003

Funded by

  • Brinson Foundation
  • Orthopaedic Research and Education Foundation

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Keywords:

  • myogenic;
  • myoid;
  • sarcoma;
  • malignant fibrous histiocytoma (MFH);
  • immunohistochemistry;
  • prognosis

Abstract

BACKGROUND

The results of a recent study demonstrated an association between myoid differentiation and an adverse prognosis in adult patients with pleomorphic sarcoma, as determined by 5-year metastasis-free survival rates.

METHODS

To confirm the importance of muscle differentiation on prognosis in a well controlled clinical context, 92 samples from patients with pleomorphic sarcoma of the extremity from a single institution were immunostained with 4 monoclonal antibodies believed to be correlated with myoid differentiation: α-smooth muscle actin, muscle-specific actin, desmin, and myoglobin.

RESULTS

Forty-two cases were positive for at least 1 muscle marker and 50 cases were uniformly negative. Between the two groups, there was no significant difference in tumor size, tumor extent, or patient age found; however, histologic grade was significantly higher (P = 0.038) in the myoid tumors. The 5-year survival differed significantly between patients with myoid tumors (35%) and those without myoid tumors (65%) (P = 0.0054). Myoid differentiation remained an adverse prognostic indicator after adjusting for clinically significant factors (i.e., histologic grade, tumor size, tumor extent, and patient age) (P = 0.01) (hazard ratio, 2.39; 95% confidence interval, 1.24–4.63). Furthermore, there was an inverse relation found between the number of myoid markers present and survival (P = 0.004).

CONCLUSIONS

Myoid differentiation was found to be an independent indicator of adverse prognosis in adult patients with pleomorphic spindle cell sarcoma of the extremity. Cancer 2003;98:805–13. © 2003 American Cancer Society.

DOI 10.1002/cncr.11617

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