Chapter 1 – Pathology and Classification
Summary: Pathology and classification
- STSs represent <1% of all malignant tumours
- Histological classification of STSs is based on the line of differentiation
- IHC is used to determine line of differentiation in STSs
- IHC can also be used as a surrogate for specific molecular alterations
- Most STSs are histologically graded (Grade 1, 2 or 3) according to FNCLCC
- Primary bone sarcomas account for only 0.2% of all neoplasms
- A multidisciplinary approach with correlation between radiological features and morphology is mandatory for a correct diagnosis in bone tumours
- Grading of most bone sarcomas is determined according to histological subtype
Further Reading
Blay JY, Sleijfer S, Schoffski P, et al. International expert opinion on patient-tailored management of soft tissue sarcomas. Eur J Cancer 2014; 50:679–689.
Blay JY, Soibinet P, Penel N, et al. Improved survival using specialized multidisciplinary board in sarcoma patients. Ann Oncol 2017; 28:2852–2859.
Casali PG, Abecassis N, Aro HT, et al. Soft tissue and visceral sarcomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29(Supplement_4):iv268–iv269.
Casali PG, Bielack S, Abecassis N, et al. Bone sarcomas: ESMO–PaedCan–EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29(Supplement_4):iv79–iv95.
Demicco EG, Lazar AJ. Clinicopathologic considerations: how can we fine tune our approach to sarcoma? Semin Oncol 2011; 38 Suppl 3:S3–18.
Evans HL, Ayala AG, Romsdahl MM. Prognostic factors in chondrosarcoma of bone: a clinicopathologic analysis with emphasis on histologic grading. Cancer 1977; 40:818–831.
Ray-Coquard I, Montesco MC, Coindre JM, et al. Sarcoma: concordance between initial diagnosis and centralized expert review in a population-based study within three European regions. Ann Oncol 2012; 23:2442–2449.
Trojani M, Contesso G, Coindre JM, et al. Soft-tissue sarcomas of adults; study of pathological prognostic variables and definition of a histopathological grading system. Int J Cancer 1984; 33:37–42.
van der Heijden L, Dijkstra PD, van de Sande MA, et al. The clinical approach toward giant cell tumor of bone. Oncologist 2014; 19:550–561.
WHO Classification of Tumours Editorial Board. Soft Tissue and Bone Tumours; WHO Classification of Tumours, 5th Edition, Volume 3. France: IACR; 2020.
WHO classification of bone sarcomas - 2 ESMO Members: Download the full book!
