Prognostic impact of P53 status, TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma: A molecular and clinicopathologic study of 82 cases

C. R. Antonescu, S. J. Tschernyavsky, R. Decuseara, D. H. Leung, J. M. Woodruff, M. F. Brennan, J. A. Bridge, J. R. Neff, J. R. Goldblum, M. Ladanyi

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Abstract

Purpose: A specific TLS-CHOP fusion gene resulting from the t(12;16) is present in at least 95% of myxoid liposarcomas (MLS). Three common forms of the TLS-CHOP fusion have been described, differing by the presence or absence of TLS exons 6-8 in the fusion product. Type 5-2 (also known as type II) consists of TLS exons 1-5 fused to CHOP exon 2; type 7-2 (also known as type I) also includes TLS exons 6 and 7 in the fusion, whereas type 8-2 (also known as type III) fuses TLS exons 1-8 to CHOP exon 2. We sought to determine the impact of TLS-CHOP fusion transcript structure on clinical outcome in a group of well-characterized MLS cases. We also analyzed P53 status, because this parameter has been found to have a significant prognostic impact in other sarcomas with chromosomal translocations. Methods: We analyzed TLS-CHOP fusion transcripts by reverse-transcription PCR using RNA extracted from frozen tissue in 82 MLS confirmed previously to harbor a CHOP rearrangement either by Southern blotting or by cytogenetic detection of the t(12;16). Parameters analyzed included age, location, size, percentage of round cell (RC) component, areas of increased cellularity, necrosis, and surgical margins. In 71 (87%) cases, adequate tumor tissue was available for immunohistochemical analysis of P53 status, using DO7 antibody. The Kaplan-Meier method, log-rank, and Cox regression tests were used for survival analyses. Results: Most MLS were >10 cm (73%), arising in the thigh (70%), and localized at presentation (89%). RC component was <5% in 47 (57%) cases and ≥5% in 35 (43%). The TLS-CHOP fusion transcript was type 5-2 in 55 (67%), type 7-2 in 16 cases (20%), and type 8-2 in 8 (10%). One tumor had a unique variant fusion, between exon 6 TLS and exon 2 CHOP. Two other cases (2%) showed an EWS-CHOP fusion transcript. Overexpression of P53 (defined as ≥10% nuclear staining) was detected in 12 (17%) cases. High histological grade (defined as ≥5% RC; P < 0.01), presence of necrosis (≥5% of tumor mass; P < 0.05), and overexpression of P53 (P < 0.001) correlated with reduced metastatic disease-free survival in localized tumors. The presence of negative surgical margins (P < 0.01) and extremity location (P = 0.02) were found to be significant in predicting local recurrence in the entire group as well as localized cases by univariate and multivariate analysis. Although there was no significant correlation between TLS-CHOP transcript type and histological grade or disease-specific survival, an association was found between the P53 status and type 5-2 fusion (P < 0.01). Conclusion: In contrast to some other translocation-associated sarcomas, the molecular variability of TLS-CHOP fusion transcript structure does not appear to have a significant impact on clinical outcome in MLS. Instead, high histological grade (≥5% RC), presence of necrosis, and P53 overexpression are predictors of unfavorable outcome in localized MLS.

Original languageEnglish (US)
Pages (from-to)3977-3987
Number of pages11
JournalClinical Cancer Research
Volume7
Issue number12
StatePublished - Jan 1 2001

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Myxoid Liposarcoma
Exons
Necrosis
Cellular Structures
Sarcoma
Neoplasms
Genetic Translocation
Gene Fusion
Survival Analysis
Southern Blotting
Thigh
Cytogenetics
Reverse Transcription
Disease-Free Survival
Multivariate Analysis
Extremities
RNA
Staining and Labeling
Recurrence
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Antonescu, C. R., Tschernyavsky, S. J., Decuseara, R., Leung, D. H., Woodruff, J. M., Brennan, M. F., ... Ladanyi, M. (2001). Prognostic impact of P53 status, TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma: A molecular and clinicopathologic study of 82 cases. Clinical Cancer Research, 7(12), 3977-3987.

Prognostic impact of P53 status, TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma : A molecular and clinicopathologic study of 82 cases. / Antonescu, C. R.; Tschernyavsky, S. J.; Decuseara, R.; Leung, D. H.; Woodruff, J. M.; Brennan, M. F.; Bridge, J. A.; Neff, J. R.; Goldblum, J. R.; Ladanyi, M.

In: Clinical Cancer Research, Vol. 7, No. 12, 01.01.2001, p. 3977-3987.

Research output: Contribution to journalArticle

Antonescu, CR, Tschernyavsky, SJ, Decuseara, R, Leung, DH, Woodruff, JM, Brennan, MF, Bridge, JA, Neff, JR, Goldblum, JR & Ladanyi, M 2001, 'Prognostic impact of P53 status, TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma: A molecular and clinicopathologic study of 82 cases', Clinical Cancer Research, vol. 7, no. 12, pp. 3977-3987.
Antonescu, C. R. ; Tschernyavsky, S. J. ; Decuseara, R. ; Leung, D. H. ; Woodruff, J. M. ; Brennan, M. F. ; Bridge, J. A. ; Neff, J. R. ; Goldblum, J. R. ; Ladanyi, M. / Prognostic impact of P53 status, TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma : A molecular and clinicopathologic study of 82 cases. In: Clinical Cancer Research. 2001 ; Vol. 7, No. 12. pp. 3977-3987.
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title = "Prognostic impact of P53 status, TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma: A molecular and clinicopathologic study of 82 cases",
abstract = "Purpose: A specific TLS-CHOP fusion gene resulting from the t(12;16) is present in at least 95{\%} of myxoid liposarcomas (MLS). Three common forms of the TLS-CHOP fusion have been described, differing by the presence or absence of TLS exons 6-8 in the fusion product. Type 5-2 (also known as type II) consists of TLS exons 1-5 fused to CHOP exon 2; type 7-2 (also known as type I) also includes TLS exons 6 and 7 in the fusion, whereas type 8-2 (also known as type III) fuses TLS exons 1-8 to CHOP exon 2. We sought to determine the impact of TLS-CHOP fusion transcript structure on clinical outcome in a group of well-characterized MLS cases. We also analyzed P53 status, because this parameter has been found to have a significant prognostic impact in other sarcomas with chromosomal translocations. Methods: We analyzed TLS-CHOP fusion transcripts by reverse-transcription PCR using RNA extracted from frozen tissue in 82 MLS confirmed previously to harbor a CHOP rearrangement either by Southern blotting or by cytogenetic detection of the t(12;16). Parameters analyzed included age, location, size, percentage of round cell (RC) component, areas of increased cellularity, necrosis, and surgical margins. In 71 (87{\%}) cases, adequate tumor tissue was available for immunohistochemical analysis of P53 status, using DO7 antibody. The Kaplan-Meier method, log-rank, and Cox regression tests were used for survival analyses. Results: Most MLS were >10 cm (73{\%}), arising in the thigh (70{\%}), and localized at presentation (89{\%}). RC component was <5{\%} in 47 (57{\%}) cases and ≥5{\%} in 35 (43{\%}). The TLS-CHOP fusion transcript was type 5-2 in 55 (67{\%}), type 7-2 in 16 cases (20{\%}), and type 8-2 in 8 (10{\%}). One tumor had a unique variant fusion, between exon 6 TLS and exon 2 CHOP. Two other cases (2{\%}) showed an EWS-CHOP fusion transcript. Overexpression of P53 (defined as ≥10{\%} nuclear staining) was detected in 12 (17{\%}) cases. High histological grade (defined as ≥5{\%} RC; P < 0.01), presence of necrosis (≥5{\%} of tumor mass; P < 0.05), and overexpression of P53 (P < 0.001) correlated with reduced metastatic disease-free survival in localized tumors. The presence of negative surgical margins (P < 0.01) and extremity location (P = 0.02) were found to be significant in predicting local recurrence in the entire group as well as localized cases by univariate and multivariate analysis. Although there was no significant correlation between TLS-CHOP transcript type and histological grade or disease-specific survival, an association was found between the P53 status and type 5-2 fusion (P < 0.01). Conclusion: In contrast to some other translocation-associated sarcomas, the molecular variability of TLS-CHOP fusion transcript structure does not appear to have a significant impact on clinical outcome in MLS. Instead, high histological grade (≥5{\%} RC), presence of necrosis, and P53 overexpression are predictors of unfavorable outcome in localized MLS.",
author = "Antonescu, {C. R.} and Tschernyavsky, {S. J.} and R. Decuseara and Leung, {D. H.} and Woodruff, {J. M.} and Brennan, {M. F.} and Bridge, {J. A.} and Neff, {J. R.} and Goldblum, {J. R.} and M. Ladanyi",
year = "2001",
month = "1",
day = "1",
language = "English (US)",
volume = "7",
pages = "3977--3987",
journal = "Clinical Cancer Research",
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TY - JOUR

T1 - Prognostic impact of P53 status, TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma

T2 - A molecular and clinicopathologic study of 82 cases

AU - Antonescu, C. R.

AU - Tschernyavsky, S. J.

AU - Decuseara, R.

AU - Leung, D. H.

AU - Woodruff, J. M.

AU - Brennan, M. F.

AU - Bridge, J. A.

AU - Neff, J. R.

AU - Goldblum, J. R.

AU - Ladanyi, M.

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Purpose: A specific TLS-CHOP fusion gene resulting from the t(12;16) is present in at least 95% of myxoid liposarcomas (MLS). Three common forms of the TLS-CHOP fusion have been described, differing by the presence or absence of TLS exons 6-8 in the fusion product. Type 5-2 (also known as type II) consists of TLS exons 1-5 fused to CHOP exon 2; type 7-2 (also known as type I) also includes TLS exons 6 and 7 in the fusion, whereas type 8-2 (also known as type III) fuses TLS exons 1-8 to CHOP exon 2. We sought to determine the impact of TLS-CHOP fusion transcript structure on clinical outcome in a group of well-characterized MLS cases. We also analyzed P53 status, because this parameter has been found to have a significant prognostic impact in other sarcomas with chromosomal translocations. Methods: We analyzed TLS-CHOP fusion transcripts by reverse-transcription PCR using RNA extracted from frozen tissue in 82 MLS confirmed previously to harbor a CHOP rearrangement either by Southern blotting or by cytogenetic detection of the t(12;16). Parameters analyzed included age, location, size, percentage of round cell (RC) component, areas of increased cellularity, necrosis, and surgical margins. In 71 (87%) cases, adequate tumor tissue was available for immunohistochemical analysis of P53 status, using DO7 antibody. The Kaplan-Meier method, log-rank, and Cox regression tests were used for survival analyses. Results: Most MLS were >10 cm (73%), arising in the thigh (70%), and localized at presentation (89%). RC component was <5% in 47 (57%) cases and ≥5% in 35 (43%). The TLS-CHOP fusion transcript was type 5-2 in 55 (67%), type 7-2 in 16 cases (20%), and type 8-2 in 8 (10%). One tumor had a unique variant fusion, between exon 6 TLS and exon 2 CHOP. Two other cases (2%) showed an EWS-CHOP fusion transcript. Overexpression of P53 (defined as ≥10% nuclear staining) was detected in 12 (17%) cases. High histological grade (defined as ≥5% RC; P < 0.01), presence of necrosis (≥5% of tumor mass; P < 0.05), and overexpression of P53 (P < 0.001) correlated with reduced metastatic disease-free survival in localized tumors. The presence of negative surgical margins (P < 0.01) and extremity location (P = 0.02) were found to be significant in predicting local recurrence in the entire group as well as localized cases by univariate and multivariate analysis. Although there was no significant correlation between TLS-CHOP transcript type and histological grade or disease-specific survival, an association was found between the P53 status and type 5-2 fusion (P < 0.01). Conclusion: In contrast to some other translocation-associated sarcomas, the molecular variability of TLS-CHOP fusion transcript structure does not appear to have a significant impact on clinical outcome in MLS. Instead, high histological grade (≥5% RC), presence of necrosis, and P53 overexpression are predictors of unfavorable outcome in localized MLS.

AB - Purpose: A specific TLS-CHOP fusion gene resulting from the t(12;16) is present in at least 95% of myxoid liposarcomas (MLS). Three common forms of the TLS-CHOP fusion have been described, differing by the presence or absence of TLS exons 6-8 in the fusion product. Type 5-2 (also known as type II) consists of TLS exons 1-5 fused to CHOP exon 2; type 7-2 (also known as type I) also includes TLS exons 6 and 7 in the fusion, whereas type 8-2 (also known as type III) fuses TLS exons 1-8 to CHOP exon 2. We sought to determine the impact of TLS-CHOP fusion transcript structure on clinical outcome in a group of well-characterized MLS cases. We also analyzed P53 status, because this parameter has been found to have a significant prognostic impact in other sarcomas with chromosomal translocations. Methods: We analyzed TLS-CHOP fusion transcripts by reverse-transcription PCR using RNA extracted from frozen tissue in 82 MLS confirmed previously to harbor a CHOP rearrangement either by Southern blotting or by cytogenetic detection of the t(12;16). Parameters analyzed included age, location, size, percentage of round cell (RC) component, areas of increased cellularity, necrosis, and surgical margins. In 71 (87%) cases, adequate tumor tissue was available for immunohistochemical analysis of P53 status, using DO7 antibody. The Kaplan-Meier method, log-rank, and Cox regression tests were used for survival analyses. Results: Most MLS were >10 cm (73%), arising in the thigh (70%), and localized at presentation (89%). RC component was <5% in 47 (57%) cases and ≥5% in 35 (43%). The TLS-CHOP fusion transcript was type 5-2 in 55 (67%), type 7-2 in 16 cases (20%), and type 8-2 in 8 (10%). One tumor had a unique variant fusion, between exon 6 TLS and exon 2 CHOP. Two other cases (2%) showed an EWS-CHOP fusion transcript. Overexpression of P53 (defined as ≥10% nuclear staining) was detected in 12 (17%) cases. High histological grade (defined as ≥5% RC; P < 0.01), presence of necrosis (≥5% of tumor mass; P < 0.05), and overexpression of P53 (P < 0.001) correlated with reduced metastatic disease-free survival in localized tumors. The presence of negative surgical margins (P < 0.01) and extremity location (P = 0.02) were found to be significant in predicting local recurrence in the entire group as well as localized cases by univariate and multivariate analysis. Although there was no significant correlation between TLS-CHOP transcript type and histological grade or disease-specific survival, an association was found between the P53 status and type 5-2 fusion (P < 0.01). Conclusion: In contrast to some other translocation-associated sarcomas, the molecular variability of TLS-CHOP fusion transcript structure does not appear to have a significant impact on clinical outcome in MLS. Instead, high histological grade (≥5% RC), presence of necrosis, and P53 overexpression are predictors of unfavorable outcome in localized MLS.

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