Fax: (734) 763-4095
Primary versus radiation-associated craniofacial osteosarcoma
Biologic and clinicopathologic comparisons†
Article first published online: 22 JUN 2006
Copyright © 2006 American Cancer Society
Volume 107, Issue 3, pages 554–562, 1 August 2006
How to Cite
McHugh, J. B., Thomas, D. G., Herman, J. M., Ray, M. E., Baker, L. H., Adsay, N. V., Rabah, R. and Lucas, D. R. (2006), Primary versus radiation-associated craniofacial osteosarcoma. Cancer, 107: 554–562. doi: 10.1002/cncr.22019
The results of this study were presented in parts at the 10th Annual Meeting of the Connective Tissue Oncology Society, Montreal, Quebec, Canada, November 11–13, 2004; and the 94th Annual Meeting of the United States and Canadian Academy of Pathologists, San Antonio, Texas, February 26–March 4, 2005.
- Issue published online: 18 JUL 2006
- Article first published online: 22 JUN 2006
- Manuscript Accepted: 21 MAR 2006
- Manuscript Revised: 28 FEB 2006
- Manuscript Received: 2 DEC 2005
- Robert Urich Memorial Sarcoma Fund at the University of Michigan
- jaw neoplasms;
- bone neoplasms;
- protein p53;
- p53 gene;
- Ki-67 antigen;
- MIB-1 antibody;
Craniofacial osteosarcoma differs from long bone osteosarcoma in that patients are older, tumors are often low grade, and prognosis is more favorable. Although most are sporadic, some tumors occur in association with prior radiation therapy. The purpose of the current study was to compare clinicopathologic and prognostic features of primary and radiation-associated osteosarcoma.
The study group consisted of 15 primary and 6 radiation-associated osteosarcomas. Clinical and follow-up data were obtained in every case. Tissue microarrays were immunohistochemically stained for p53, pRB, Ki-67 (MIB-1), and ezrin. DNA was sequenced for TP53 mutations.
All radiation-associated osteosarcomas were high grade and half were fibroblastic. In contrast, 47% of primary craniofacial osteosarcomas were high grade and only 1 was fibroblastic. All radiation-associated osteosarcomas recurred, half the patients died of disease, 2 were alive with unresectable tumors, whereas only 1 was alive without disease. In contrast, 80% of patients with primary tumors were alive without disease, 33% had local recurrences, and 13% died of disease. Radiation-associated tumors overexpressed p53 more often (33% vs. 13%), more often had TP53 mutations (33% vs. 8%), had higher proliferative activity (67% vs. 0% showing >50% MIB-1 staining), and expressed ezrin more frequently (83% vs. 40%) than primary tumors. Compared with a control group of 24 high- and 7 low-grade primary extremity osteosarcomas, radiation-associated tumors marked as the high-grade tumors.
Craniofacial radiation-associated osteosarcomas are high-grade tumors that behave more aggressively than most primary craniofacial osteosarcomas. In addition, they demonstrate higher expression rates of adverse prognostic indicators, further highlighting the distinction. Cancer 2006. © 2006 American Cancer Society.