Treatment pathway of bone sarcoma in children, adolescents, and young adults.

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Abstract

[Indexed for MEDLINE] 14. Ann Pathol. 2011 Dec;31(6):455-65. doi: 10.1016/j.annpat.2011.10.009. Epub 2011 Nov 29. [Place of the pathologist in the management of primary bone tumors (osteosarcoma and Ewing's family tumors after neoadjuvant treatment)]. [Article in French] Gomez-Brouchet A(1), Bouvier C, Decouvelaere AV, Larousserie F, Aubert S, Leroy X, Guinebretière JM, Coulomb A, Cassagnau E, de Muret A, Audard V, Marie B, de Pinieux G. Author information: (1)Service de pathologie, département d'anatomie et cytologie pathologiques, Toulouse, France. brouchet.anne@chu-toulouse.fr 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. Copyright © 2011 Elsevier Masson SAS. All rights reserved. DOI: 10.1016/j.annpat.2011.10.009