ORIGINAL ARTICLE

Prognostic relevance of rosette-like features in osteosarcoma

K Okada¹, T Hasegawa², R Yokoyama³, Y Beppu³, E Itoi¹

¹ Department of Orthopaedic Surgery, Akita University School of Medicine, Akita 010-8543, Japan
² Pathology Division, National Cancer Centre Research Institute, Tokyo 104-0045, Japan
³ Orthopaedic Divisions, National Cancer Centre Research Institute and Hospital, Tokyo 104-0045, Japan

Correspondence to:
Correspondence to:
Dr K Okada
MD, Department of Orthopaedic Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; cshokada{at}med.akita-u.ac.jp

Aims: 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.

Keywords: osteosarcoma; rosette; chemotherapy; prognosis

Abbreviations: EMA, epithelial membrane antigen; RR, relative risk

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