Annals of Surgical Oncology

, Volume 19, Issue 6, pp 1790–1799 | Cite as

Prognostication of Soft Tissue Sarcomas Based on Chromosome 17q Gene and Protein Status: Evaluation of TOP2A, HER-2/neu, and Survivin

  • Isabela Werneck da Cunha
  • Louise De Brot
  • Kátia Cândido Carvalho
  • Rafael Malagoli Rocha
  • José Humberto Fregnani
  • Roberto Falzoni
  • Fábio de Oliveira Ferreira
  • Samuel Aguiar Júnior
  • Ademar Lopes
  • Nair Hideko Muto
  • Luiz F. L. Reis
  • Fernando Augusto Soares
  • José Vassallo
Bone and Soft Tissue Sarcomas



Topoisomerase 2 alpha (TOP2A), HER-2/neu, and survivin are genes that lie on chromosome 17 and correlate with the prognosis and prediction of target-driven therapy against tumors. In a previous study, we showed that TOP2A transcripts levels were significantly higher in soft tissue sarcomas (STS) than in benign tumors and desmoid-type fibromatoses (FM). Because these genes have been insufficiently examined in STS, we aimed to identify alterations in TOP2A and HER-2 expression by fluorescent in situ hybridization and immunohistochemistry, as well as that of survivin, and correlate them with clinicopathologic findings to assess their prognostic value.


Eighteen FM and 244 STS were included. Fluorescent in situ hybridization and immunohistochemistry were performed on a tissue microarray.


TOP2A and survivin were more highly expressed in sarcomas than in FM. TOP2A was an independent predictor of an unfavorable prognosis; it was combined with formerly established prognostic factors (primarily histologic grade and tumor size at diagnosis) to create a prognostic index that evaluated overall survival. Gene amplification/polysomy (13%) did not correlate with protein overexpression. Survivin and HER-2 expression were not associated with patient outcomes.


These findings might become valuable in the management of patients with STS and possibly in the prospective evaluation of responses to new target-driven therapies.


Sarcoma Soft Tissue Sarcoma Synovial Sarcoma Malignant Peripheral Nerve Sheath Tumor Survivin Expression 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported by FAPESP (Fundação de Amparo à Pesquisa do Estado de São Paulo, Brazil). J.V. and F.A.S. are researchers of the CNPq (Conselho Nacional do Desenvolvimento Científico, Brazil).

Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Isabela Werneck da Cunha
    • 1
  • Louise De Brot
    • 1
  • Kátia Cândido Carvalho
    • 1
    • 2
  • Rafael Malagoli Rocha
    • 1
  • José Humberto Fregnani
    • 1
    • 3
  • Roberto Falzoni
    • 1
    • 4
  • Fábio de Oliveira Ferreira
    • 1
  • Samuel Aguiar Júnior
    • 1
  • Ademar Lopes
    • 1
  • Nair Hideko Muto
    • 1
  • Luiz F. L. Reis
    • 1
    • 5
  • Fernando Augusto Soares
    • 1
  • José Vassallo
    • 1
    • 6
  1. 1.Hospital do Câncer A. C. Camargo, Fundação Antonio PrudenteSão PauloBrazil
  2. 2.Laboratório de Ginecologia Estrutural e MolecularFaculdade de Medicina da Universidade de São Paulo (USP)São PauloBrazil
  3. 3.Hospital do Câncer de Barretos, São PauloSão PauloBrazil
  4. 4.Hospital das Clínicas da USPSão PauloBrazil
  5. 5.Hospital Sírio LibanêsSão PauloBrazil
  6. 6.Laboratory of Investigative and Molecular Pathology, CIPEDFaculdade de Ciências Médicas da Universidade de Campinas (Unicamp)São PauloBrazil

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