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Treatment Effects in Pediatric Soft Tissue and Bone Tumors
Practical Considerations for the Pathologist

Cheryl M. Coffin MD, Amy Lowichik MD, PhD, Holly Zhou MD
DOI: http://dx.doi.org/10.1309/H0D4VD760NH6N1R6 75-90 First published online: 1 January 2005


Dramatic improvements in survival for children with cancer have led to increased numbers of posttreatment pathologic specimens, particularly in bone and soft tissue sarcomas. Current therapeutic protocols in North America require specific pathologic classification and stratify patients based on clinical, biologic, and pathologic features. For osteosarcoma, the pathologic response to therapy predicts prognosis and modifies the treatment regimen. Ongoing studies aim to assess the response to therapy and outcome in other types of soft tissue and bone tumors. The pathologic evaluation of pretreatment and posttreatment specimens is critical for therapeutic decisions and prognostic assessment. A standardized approach to posttherapy pathologic specimens, with attention to appropriate use of ancillary tests, and assessment of clinical and biologic significance of therapy-induced pathologic changes has significance for patient management and treatment protocols.

Key Words:
  • Sarcoma
  • Treatment effects
  • Therapy-induced cytodifferentiation
  • Osteosarcoma
  • Ewing sarcoma
  • Infantile fibrosarcoma
  • Rhabdomyosarcoma
  • Synovial sarcoma