Increased mitotic and proliferative activity are associated with worse prognosis in papillary tumors of the pineal region.

Heim, Stephanie; Beschorner, Rudi; Mittelbronn, Michel; Keyvani, Kathy; Riemenschneider, Markus J; Vajtai, Istvan; Hartmann, Christian; Acker, Till; Blümcke, Ingmar; Paulus, Werner; Hasselblatt, Martin (2014). Increased mitotic and proliferative activity are associated with worse prognosis in papillary tumors of the pineal region. The American journal of surgical pathology, 38(1), pp. 106-110. Lippincott Williams & Wilkins 10.1097/PAS.0b013e31829e492d

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Papillary tumors of the pineal region are rare glial tumors located in the vicinity of the third ventricle, the clinical behavior of which is often aggressive. Little is known about the prognostic markers that might aid to identify patients at increased risk for recurrence. Therefore, the prognostic value of histopathologic and clinical features was examined in a series of 21 patients. Median age of the 12 male and 9 female patients was 35 years (range, 10 to 56 y). On histopathologic examination, all tumors were characterized by loose papillary structures and tumor cells forming broad perivascular pseudorosettes showing cytokeratin expression. In addition, tumors showed increased cellularity (n=4; 19%), nuclear pleomorphism (n=4; 19%), solid growth (n=11; 52%), necrosis (n=8; 38%), increased mitotic activity (≥3 mitoses per 10 high-power fields [n=10; 48%]), and increased proliferation (Ki67/MIB1 index ≥10% [n=8/20; 40%]). Gross total resection could be achieved in 13/21 patients (62%). Postoperatively, 13 patients received radiotherapy and 4 patients chemotherapy. Median recurrence-free survival was 66 months in 19 patients, for whom detailed follow-up information was available. Twelve patients (63%) experienced tumor progression. Three patients (16%) died of disease. Among the clinical and histopathologic features examined, only increased mitotic activity (52 [8 to 96] vs. 68 [66 to 70] mo [median [95% confidence interval]]) and proliferative activity (29 [0 to 64] vs. 67 [44 to 90] mo) were significantly associated with recurrence (P<0.05). Tumors of the 3 patients who had succumbed to disease showed increased mitotic and proliferative activity. In conclusion, increased mitotic and proliferative activities are associated with worse prognosis in papillary tumors of the pineal region.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Pathology

UniBE Contributor:

Vajtai, Istvan

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1532-0979

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Ekkehard Hewer

Date Deposited:

15 Feb 2017 14:06

Last Modified:

15 Feb 2017 14:06

Publisher DOI:

10.1097/PAS.0b013e31829e492d

PubMed ID:

24121176

BORIS DOI:

10.7892/boris.95903

URI:

https://boris.unibe.ch/id/eprint/95903

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