Journal Article

Locoregional Disease Patterns in Well-Differentiated and Dedifferentiated Retroperitoneal Liposarcoma: Implications for the Extent of Resection?

Pollock, Raphael E., Pisters, Peter W. T., Tseng, William W., Madewell, John E., Hoffman, Aviad, Somaiah, Neeta, Wei, Wei, Ghadimi, Markus P., Lev, Dina C., Lazar, Alexander J.

2014

Overview

Background Well-differentiated (WD)/dedifferentiated (DD) liposarcoma is the most common soft tissue sarcoma of the retroperitoneum. The frequency of distant metastasis is low and the major burden of disease is locoregional. We sought to define the patterns of locoregional disease to help guide surgical decision making. Methods Data were collected from 247 patients with de novo or recurrent tumors treated at our institution from 1993 to early 2012. The number and location of tumors at both initial presentation and subsequent locoregional recurrence were determined by combined analysis of operative dictations and radiologic imaging. Results Thirty-four percent of patients had multifocal locoregional disease (two or more tumors) at initial presentation to our institution, including 9 % who had tumors at synchronous remote retroperitoneal sites. The impact of multifocal disease on overall survival was dependent on histologic subtype (WD vs. DD) and disease presentation (de novo vs. recurrence) at the time of resection. Among patients with initial unifocal disease, 57 % progressed to multifocal locoregional disease with subsequent recurrence, including 11 % with new tumors outside of the original resection field. No clinicopathologic or treatment-related variable, including the type or extent of resection, was predictive of either multifocal or ‘outside field’ progression. Conclusions Multifocal disease is common in patients with WD/DD retroperitoneal liposarcoma, and tumors can also develop at remote, locoregional sites. Surgical resection remains the primary method of locoregional control in this disease; however, the aggressiveness of resection should be individualized, with consideration of both tumor and patient-related factors.

• Publisher: Springer US,Springer Nature B.V
• Subject: Adult / Aged / Aged, 80 and over / Bone and Soft Tissue Sarcomas / Cell Differentiation / Disease Progression / Female / Follow-Up Studies / Humans / Liposarcoma - pathology / Liposarcoma - surgery / Male / Medicine / Medicine & Public Health / Middle Aged / Neoplasm Recurrence, Local - pathology / Neoplasm Recurrence, Local - surgery / Neoplasm Staging / Oncology / Prognosis / Retroperitoneal Neoplasms - pathology / Retroperitoneal Neoplasms - surgery / Surgery / Surgical Oncology / Young Adult