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Muiños AC, Montes VG, Carrasco JC, Villanueva ÁFR, García GDS, Navarro EG. Primary pleomorphic liposarcoma of the cecum case report. Int J Surg Case Rep 2024; 121:109961. [PMID: 38959610 PMCID: PMC11268328 DOI: 10.1016/j.ijscr.2024.109961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/22/2024] [Accepted: 06/25/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION The pleomorphic variant is the least common and consequently, the least known subtype of liposarcomas. It represents <5 % of all liposarcomas and develops during late adulthood. PRESENTATION OF THE CASE We report the case of a 77-year-old male who presented with pain in the right iliac fossa and right inguinal region. A CT scan revealed a stony lesion at the level of the cecum. A right hemicolectomy was performed, and the pathology report was positive for pleomorphic liposarcoma. Consequently, he was referred for adjuvant radiotherapy. CLINICAL DISCUSSION Molecular analysis has validated the distinction of liposarcoma subtypes, although histological subtype remains the reliable prognostic parameter in daily practice, recent evidence suggests that genetic profiles may eventually influence risk stratification of individual patients. CONCLUSION The pleomorphic subtype of liposarcomas is infrequent, and they are very rare in the cecum, so it is currently recommended that patients be evaluated by a multidisciplinary team to make a therapeutic decision as it is a subtype of very aggressive behavior, before initiating any type of oncologic treatment.
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Affiliation(s)
- Aurelio Carrera Muiños
- Oncologic Surgeon and Professor of General Surgery, Hospital Español, Mexico City, Mexico
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2
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Han J, Zhao B, Han X, Sun T, Yue M, Hou M, Wu J, Tu M, An Y. Comprehensive Analysis of a Six-Gene Signature Predicting Survival and Immune Infiltration of Liposarcoma Patients and Deciphering Its Therapeutic Significance. Int J Mol Sci 2024; 25:7792. [PMID: 39063036 PMCID: PMC11277418 DOI: 10.3390/ijms25147792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/26/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND As a common soft tissue sarcoma, liposarcoma (LPS) is a heterogeneous malignant tumor derived from adipose tissue. Due to the high risk of metastasis and recurrence, the prognosis of LPS remains unfavorable. To improve clinical treatment, a robust risk prediction model is essential to evaluate the prognosis of LPS patients. METHODS By comprehensive analysis of data derived from GEO datasets, differentially expressed genes (DEGs) were obtained. Univariate and Lasso Cox regressions were subsequently employed to reveal distant recurrence-free survival (DRFS)-associated DEGs and develop a prognostic gene signature, which was assessed by Kaplan-Meier survival and ROC curve. GSEA and immune infiltration analyses were conducted to illuminate molecular mechanisms and immune correlations of this model in LPS progression. Furthermore, a correlation analysis was involved to decipher the therapeutic significance of this model for LPS. RESULTS A six-gene signature was developed to predict DRFS of LPS patients and showed higher precision performance in more aggressive LPS subtypes. Then, a nomogram was further established for clinical application based on this risk model. Via GSEA, the high-risk group was significantly enriched in cell cycle-related pathways. In the LPS microenvironment, neutrophils, memory B cells and resting mast cells exhibited significant differences in cell abundance between high-risk and low-risk patients. Moreover, this model was significantly correlated with therapeutic targets. CONCLUSION A prognostic six-gene signature was developed and significantly associated with cell cycle pathways and therapeutic target genes, which could provide new insights into risk assessment of LPS progression and therapeutic strategies for LPS patients to improve their prognosis.
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Affiliation(s)
- Jiayang Han
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng 475004, China
- Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key Laboratory of Cell Signal Transduction, Henan University, Kaifeng 475004, China
| | - Binbin Zhao
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng 475004, China
- Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key Laboratory of Cell Signal Transduction, Henan University, Kaifeng 475004, China
| | - Xu Han
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng 475004, China
- Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key Laboratory of Cell Signal Transduction, Henan University, Kaifeng 475004, China
| | - Tiantian Sun
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng 475004, China
- Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key Laboratory of Cell Signal Transduction, Henan University, Kaifeng 475004, China
| | - Man Yue
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng 475004, China
- Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key Laboratory of Cell Signal Transduction, Henan University, Kaifeng 475004, China
| | - Mengwen Hou
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng 475004, China
- Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key Laboratory of Cell Signal Transduction, Henan University, Kaifeng 475004, China
| | - Jialin Wu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng 475004, China
- Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key Laboratory of Cell Signal Transduction, Henan University, Kaifeng 475004, China
| | - Mengjie Tu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng 475004, China
- Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key Laboratory of Cell Signal Transduction, Henan University, Kaifeng 475004, China
| | - Yang An
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng 475004, China
- Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key Laboratory of Cell Signal Transduction, Henan University, Kaifeng 475004, China
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3
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Lesovaya EA, Fetisov TI, Bokhyan BY, Maksimova VP, Kulikov EP, Belitsky GA, Kirsanov KI, Yakubovskaya MG. Genetic, Epigenetic and Transcriptome Alterations in Liposarcoma for Target Therapy Selection. Cancers (Basel) 2024; 16:271. [PMID: 38254762 PMCID: PMC10813500 DOI: 10.3390/cancers16020271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/25/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
Liposarcoma (LPS) is one of the most common adult soft-tissue sarcomas (STS), characterized by a high diversity of histopathological features as well as to a lesser extent by a spectrum of molecular abnormalities. Current targeted therapies for STS do not include a wide range of drugs and surgical resection is the mainstay of treatment for localized disease in all subtypes, while many LPS patients initially present with or ultimately progress to advanced disease that is either unresectable, metastatic or both. The understanding of the molecular characteristics of liposarcoma subtypes is becoming an important option for the detection of new potential targets and development novel, biology-driven therapies for this disease. Innovative therapies have been introduced and they are currently part of preclinical and clinical studies. In this review, we provide an analysis of the molecular genetics of liposarcoma followed by a discussion of the specific epigenetic changes in these malignancies. Then, we summarize the peculiarities of the key signaling cascades involved in the pathogenesis of the disease and possible novel therapeutic approaches based on a better understanding of subtype-specific disease biology. Although heterogeneity in liposarcoma genetics and phenotype as well as the associated development of resistance to therapy make difficult the introduction of novel therapeutic targets into the clinic, recently a number of targeted therapy drugs were proposed for LPS treatment. The most promising results were shown for CDK4/6 and MDM2 inhibitors as well as for the multi-kinase inhibitors anlotinib and sunitinib.
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Affiliation(s)
- Ekaterina A. Lesovaya
- N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia, 24 Kashirskoe Shosse, Moscow 115478, Russia; (E.A.L.); (T.I.F.); (B.Y.B.); (V.P.M.); (K.I.K.)
- Faculty of Oncology, I.P. Pavlov Ryazan State Medical University, Ministry of Health of Russia, 9 Vysokovol’tnaya St., Ryazan 390026, Russia;
- Laboratory of Single Cell Biology, Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya St., Moscow 117198, Russia
| | - Timur I. Fetisov
- N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia, 24 Kashirskoe Shosse, Moscow 115478, Russia; (E.A.L.); (T.I.F.); (B.Y.B.); (V.P.M.); (K.I.K.)
| | - Beniamin Yu. Bokhyan
- N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia, 24 Kashirskoe Shosse, Moscow 115478, Russia; (E.A.L.); (T.I.F.); (B.Y.B.); (V.P.M.); (K.I.K.)
| | - Varvara P. Maksimova
- N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia, 24 Kashirskoe Shosse, Moscow 115478, Russia; (E.A.L.); (T.I.F.); (B.Y.B.); (V.P.M.); (K.I.K.)
| | - Evgeny P. Kulikov
- Faculty of Oncology, I.P. Pavlov Ryazan State Medical University, Ministry of Health of Russia, 9 Vysokovol’tnaya St., Ryazan 390026, Russia;
| | - Gennady A. Belitsky
- N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia, 24 Kashirskoe Shosse, Moscow 115478, Russia; (E.A.L.); (T.I.F.); (B.Y.B.); (V.P.M.); (K.I.K.)
| | - Kirill I. Kirsanov
- N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia, 24 Kashirskoe Shosse, Moscow 115478, Russia; (E.A.L.); (T.I.F.); (B.Y.B.); (V.P.M.); (K.I.K.)
- Laboratory of Single Cell Biology, Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya St., Moscow 117198, Russia
| | - Marianna G. Yakubovskaya
- N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia, 24 Kashirskoe Shosse, Moscow 115478, Russia; (E.A.L.); (T.I.F.); (B.Y.B.); (V.P.M.); (K.I.K.)
- Laboratory of Single Cell Biology, Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya St., Moscow 117198, Russia
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Lu J, Wood D, Ingley E, Koks S, Wong D. Update on genomic and molecular landscapes of well-differentiated liposarcoma and dedifferentiated liposarcoma. Mol Biol Rep 2021; 48:3637-3647. [PMID: 33893924 DOI: 10.1007/s11033-021-06362-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/16/2021] [Indexed: 01/13/2023]
Abstract
Well-differentiated liposarcoma (WDLPS) is the most frequent subtype of liposarcoma and may transform into dedifferentiated liposarcoma (DDLPS) which is a more aggressive subtype. Retroperitoneal lesions of WDLPS/DDLPS tend to recur repeatedly due to incomplete resections, and adjuvant chemotherapy and radiotherapy have little effect on patient survival. Consequently, identifying therapeutic targets and developing targeted drugs is critical for improving the outcome of WDLPS/DDLPS patients. In this review, we summarised the mutational landscape of WDLPS/DDLPS from recent studies focusing on potential oncogenic drivers and the development of molecular targeted drugs for DDLPS. Due to the limited number of studies on the molecular networks driving WDLPS to DDLPS development, we looked at other dedifferentiation-related tumours to identify potential parallel mechanisms that could be involved in the dedifferentiation process generating DDLPS.
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Affiliation(s)
- Jun Lu
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, 6009, Australia. .,Cell Signalling Group, Harry Perkins Institute of Medical Research and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia.
| | - David Wood
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, 6009, Australia
| | - Evan Ingley
- Cell Signalling Group, Harry Perkins Institute of Medical Research and Centre for Medical Research, The University of Western Australia, Perth, WA, 6009, Australia.,Discipline of Medical, Molecular and Forensic Sciences, College of Science, Health, Engineering and Education, Murdoch University, Perth, WA, 6009, Australia
| | - Sulev Koks
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia.,Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, 6009, Australia
| | - Daniel Wong
- Anatomical Pathology, PathWest, QEII Medical Centre, Perth, WA, 6009, Australia
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Zuco V, Pasquali S, Tortoreto M, Brich S, Percio S, Dagrada GP, Colombo C, Sanfilippo R, Lauricella C, Gounder M, El Bezawy R, Barisella M, Dei Tos AP, Casali PG, Gronchi A, Stacchiotti S, Zaffaroni N. Selinexor versus doxorubicin in dedifferentiated liposarcoma PDXs: evidence of greater activity and apoptotic response dependent on p53 nuclear accumulation and survivin down-regulation. J Exp Clin Cancer Res 2021; 40:83. [PMID: 33648535 PMCID: PMC7923610 DOI: 10.1186/s13046-021-01886-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/17/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Dedifferentiated liposarcoma (DDLPS), a tumor that lacks effective treatment strategies and is associated with poor outcomes, expresses amplified MDM2 in the presence of wild-type p53. MDM2 ubiquitination of p53 facilitates its XPO1-mediated nuclear export, thus limiting p53 tumor suppressor functions. Consequently, nuclear export is a rational target in DDLPS. We directly compared the antitumor activity of the first-in class XPO1 inhibitor selinexor and doxorubicin, the standard front-line therapy in sarcomas, in DDLPS patient-derived xenografts (PDXs) and primary cell lines. METHODS Drug activity was assessed in three PDXs (and two corresponding cell lines) established from the dedifferentiated component of primary untreated retroperitoneal DDLPS with myogenic (N = 2) and rhabdomyoblastic (N = 1) differentiation from patients who underwent surgery. These models were marked by amplification of MDM2, CDK4 and HMGA2 genes. RESULTS Selinexor was moderately active in the three PDXs but achieved greater tumor response compared to doxorubicin (maximum tumor volume inhibition: 46-80 % vs. 37-60 %). The PDX harboring rhabdomyoblastic dedifferentiation showed the highest sensitivity to both agents. PDX response to selinexor and doxorubicin was not associated with the extent of MDM2 and CDK4 gene amplification. Interestingly, the most chemosensitive PDX model showed the lowest extent of HMGA2 amplification. Selinexor was also more efficient than doxorubicinin in inducing an apoptotic response in PDXs and cell lines. Consistently, an increased nuclear accumulation of p53 was seen in all selinexor-treated models. In addition, a time-dependent decrease of survivin expression, with an almost complete abrogation of the cytoplasmic anti-apoptotic pool of this protein, was observed as a consequence of the decreased acetylation/activation of STAT3 and the increased ubiquitination of nuclear survivin. CONCLUSIONS Selinexor showed a moderate antitumor activity in three DDLPS PDXs, which was, however, consistently higher than doxorubicin across all different models regardless the extent of MDM2 amplification and the histological differentiation. The depletion of survivin protein seems to significantly contribute to the induction of apoptosis through which selinexor exerts its antitumor activity.
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Affiliation(s)
- Valentina Zuco
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori, Via Amadeo 42, 20133, Milan, Italy
| | - Sandro Pasquali
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori, Via Amadeo 42, 20133, Milan, Italy
| | - Monica Tortoreto
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori, Via Amadeo 42, 20133, Milan, Italy
| | - Silvia Brich
- Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian 1, 20133, Milan, Italy
| | - Stefano Percio
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori, Via Amadeo 42, 20133, Milan, Italy
| | - Gian Paolo Dagrada
- Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian 1, 20133, Milan, Italy
| | - Chiara Colombo
- Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian 1, 20133, Milan, Italy
| | - Roberta Sanfilippo
- Adult Mesenchymal Tumor and Rare Cancer Unit, Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian 1, 20133, Milan, Italy
| | | | - Mrinal Gounder
- Sarcoma Medical Oncology and Early Drug Development, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, 10065, New York, NY, USA
| | - Rihan El Bezawy
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori, Via Amadeo 42, 20133, Milan, Italy
| | - Marta Barisella
- Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian 1, 20133, Milan, Italy
| | - Angelo Paolo Dei Tos
- Department of Medicine, University of Padua School of Medicine, Via Giustiniani 2, 35128, Padua, Italy
| | - Paolo Giovanni Casali
- Adult Mesenchymal Tumor and Rare Cancer Unit, Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian 1, 20133, Milan, Italy
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Via Grassi 74, 20157, Milan, Italy
| | - Alessandro Gronchi
- Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian 1, 20133, Milan, Italy
| | - Silvia Stacchiotti
- Adult Mesenchymal Tumor and Rare Cancer Unit, Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian 1, 20133, Milan, Italy
| | - Nadia Zaffaroni
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori, Via Amadeo 42, 20133, Milan, Italy.
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Abstract
Objective:to conduct a systematic literature review of the published studies on retroperitoneal non-organ liposarcomas.Material and Methods.A literature search was performed using Pubmed, Elibrary, COSMIC databases. The data of retrospective and prospective clinical trials were analyzed. Results. The article reviews contemporary data on epidemiology, classification, clinicalmorphological and molecular-genetic characteristics, as well as diagnosis and treatment of retroperitoneal non-organ liposarcomas. Conclusion. Retroperitoneal sarcomas account for about 13 % of all types of soft tissue sarcomas. Liposarcoma is the most common retroperitoneal mesenchymal tumor. Diagnosis and treatment of non-organ retroperitoneal liposarcoma remain challenging due to poor long-term treatment outcomes. As experience is gained with the diagnosis and treatment of retroperitoneal nonorganic liposarcomas, changes occur in the system of understanding the problem that determines the strategy for providing medical care in this category of patients. The article presents modern concept of retroperitoneal non-organ liposarcomas.
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Affiliation(s)
- A. Yu. Volkov
- N. N. Blokhin National Medical Research Centre of Oncology, Health Ministry of Russia
| | - S. N. Nered
- N. N. Blokhin National Medical Research Centre of Oncology, Health Ministry of Russia
| | - L. N. Lyubchenko
- N. N. Blokhin National Medical Research Centre of Oncology, Health Ministry of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation
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7
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Jo EB, Lee YS, Lee H, Park JB, Park H, Choi YL, Hong D, Kim SJ. Combination therapy with c-met inhibitor and TRAIL enhances apoptosis in dedifferentiated liposarcoma patient-derived cells. BMC Cancer 2019; 19:496. [PMID: 31126284 PMCID: PMC6534902 DOI: 10.1186/s12885-019-5713-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 05/14/2019] [Indexed: 12/12/2022] Open
Abstract
Background Liposarcoma (LPS) is a tumor derived from adipose tissue, and has the highest incidence among soft tissue sarcomas. Dedifferentiated liposarcoma (DDLPS) is a malignant tumor with poor prognosis. Recurrence and metastasis rates in LPS remain high even after chemotherapy and radiotherapy following complete resection. Therefore, the development of advanced treatment strategies for LPS is required. In the present study, we investigated the effect of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) treatment, and of combination treatment using TRAIL and a c-Met inhibitor on cell viability and apoptosis in LPS and DDLPS cell lines of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) treatment, and of combination treatment using TRAIL and a c-Met inhibitor. Methods We analyzed cell viability after treatment with TRAIL and a c-Met inhibitor by measuring CCK8 and death receptor 5 (DR5) expression levels via fluorescence activated cell sorting (FACS) in both sarcoma cell lines and DDLPS patient-derived cells (PDCs). Moreover, we validated the effects of TRAIL alone and in combination with c-Met inhibitor on apoptosis in LPS cell lines and DDLPS PDCs via FACS. Results Our results revealed that combination treatment with a c-Met inhibitor and human recombinant TRAIL (rhTRAIL) suppressed cell viability and induced cell death in both sarcoma cell lines and DDLPS PDCs, which showed varying sensitivities to rhTRAIL alone. Also, we confirmed that treatment with a c-Met inhibitor upregulated DR5 levels in sarcoma cell lines and DDLPS PDCs. In both TRAIL-susceptible and TRAIL-resistant cells subjected to combination treatment, promotion of apoptosis was dependent on DR5 upregulation. Conclusion From these results, our findings validated that DR5 up-regulation caused by combination therapy with a c-Met inhibitor and rhTRAIL enhanced TRAIL sensitization and promoted apoptosis. We propose the use of this approach to overcome TRAIL resistance and serve as a novel treatment strategy for clinical trials. Electronic supplementary material The online version of this article (10.1186/s12885-019-5713-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eun Byeol Jo
- Sarcoma Research Center, Samsung Biomedical Research Institute, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Samsung Advanced Institute for Health Sciences and Technology, SKKU, Seoul, Republic of Korea
| | - Young Sang Lee
- Sarcoma Research Center, Samsung Biomedical Research Institute, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Samsung Advanced Institute for Health Sciences and Technology, SKKU, Seoul, Republic of Korea
| | - Hyunjoo Lee
- Personalized Medicine, Children's Cancer Institute Australia, Sydney, NSW, Australia
| | - Jae Berm Park
- Department of Surgery, Samsung Medical Center, SungKyunKwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Hyojun Park
- Department of Surgery, Samsung Medical Center, SungKyunKwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Yoon-La Choi
- Sarcoma Research Center, Samsung Biomedical Research Institute, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Department of Pathology, Samsung Medical Center, Seoul, Republic of Korea
| | - Doopyo Hong
- Sarcoma Research Center, Samsung Biomedical Research Institute, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Sung Joo Kim
- Sarcoma Research Center, Samsung Biomedical Research Institute, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. .,Samsung Advanced Institute for Health Sciences and Technology, SKKU, Seoul, Republic of Korea. .,Department of Surgery, Samsung Medical Center, SungKyunKwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
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8
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Xin Q, Liu X, Yu X, Ye J, Peng X, Zhou M, Zhang P. Primary retroperitoneal liposarcoma with extensive ossification: A case report. Medicine (Baltimore) 2019; 98:e14996. [PMID: 30921215 PMCID: PMC6456147 DOI: 10.1097/md.0000000000014996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Primary retroperitoneal liposarcoma, which originates from mesenchymal tissues, can rarely present with extensive ossification. PATIENT CONCERNS A 41-year-old male patient presented with a chief complaint of discomfort around the waist for 2 months. DIAGNOSES Computerized tomography (CT) and magnetic resonance imaging suggested a lesion of approximately 5.6 × 5.1 × 8.7 cm in front of the psoas major muscle, which was considered to be a mesenchymal or neurogenic tumor. INTERVENTIONS The hard mass was removed by laparotomy, and the pathological investigation revealed that this was an atypical lipomatous tumor/well-differentiated liposarcoma, with extensive ossification. OUTCOMES The patient was discharged from the hospital after surgery. There was no sign of reoccurrence after 1 year of follow-up. LESSONS Retroperitoneal liposarcomas with extensive ossification are rare tumors that can present with nonspecific symptoms, and are difficult to diagnose. CT is the most common imaging technique, and surgical resection has been considered to be the most effective treatment. This rare case can be challenging for diagnosis and treatment.
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Affiliation(s)
- Qi Xin
- Department of Hepatopancreatobiliary Surgery
| | - Xingkai Liu
- Department of Hepatopancreatobiliary Surgery
| | - Xiaoyuan Yu
- Department of Hematology, The First Bethune Hospital of Jilin University, Changchun, China
| | - Junfeng Ye
- Department of Hepatopancreatobiliary Surgery
| | | | | | - Ping Zhang
- Department of Hepatopancreatobiliary Surgery
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Sultania M, Muduly D, Jha S, Kar M, Mitra S. Primary colonic liposarcomatosis: report of a case with review of literature. AUTOPSY AND CASE REPORTS 2019; 9:e2018056. [PMID: 30863730 PMCID: PMC6394358 DOI: 10.4322/acr.2018.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 09/18/2018] [Indexed: 01/16/2023] Open
Abstract
The colon is a rare site of occurrence of liposarcoma, as either the primary site or by secondary involvement from a retroperitoneal liposarcoma. Liposarcomatosis denotes simultaneous occurrence of multiple liposarcomas. There are only 17 cases of primary colonic liposarcoma reported in the English literature-one of which was primary colonic liposarcomatosis. We depict the second case of primary colonic liposarcomatosis in a 57-year-old female who presented with abdominal swelling and pain. On exploratory laparotomy, two large masses were seen arising from the wall of the right colon along with multiple smaller masses attached to the colon. Right hemicolectomy with en bloc excision of the masses was performed along with hysterectomy and pelvic floor repair. Macroscopically, multiple exophytic masses and one endophytic mass were identified. The exophytic masses were of variable size and were found to hang from the colon by a thin pedicle simulating variable-sized appendices epiploicae. Histopathologically, the lesions showed the morphology of well-differentiated liposarcoma. This appears to be a case of primary colonic liposarcomatosis. There is only one other similar case reported in the English literature, to the best of our knowledge.
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Affiliation(s)
- Mahesh Sultania
- All India Institute of Medical Sciences, Department of Surgical Oncology. Bhubaneswar, Orissa, India
| | - Dillip Muduly
- All India Institute of Medical Sciences, Department of Surgical Oncology. Bhubaneswar, Orissa, India
| | - Shilpy Jha
- All India Institute of Medical Sciences, Department of Pathology and Laboratory Medicine, Bhubaneswar, Orissa, India
| | - Madhabananda Kar
- All India Institute of Medical Sciences, Department of Surgical Oncology. Bhubaneswar, Orissa, India
| | - Suvradeep Mitra
- All India Institute of Medical Sciences, Department of Pathology and Laboratory Medicine, Bhubaneswar, Orissa, India
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Kim JH, Lee JS, Kim EJ, Park KH, Kim KH, Yi SY, Kim HS, Cho YJ, Shin KH, Ahn JB, Hu H, Kim KS, Choi YD, Kim S, Lee YH, Suh JS, Noh SH, Rha SY, Kim HS. Prognostic implications of PIK3CA amplification in curatively resected liposarcoma. Oncotarget 2017; 7:24549-58. [PMID: 27016421 PMCID: PMC5029721 DOI: 10.18632/oncotarget.8240] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/02/2016] [Indexed: 11/25/2022] Open
Abstract
Background We investigated the epidemiologic characteristics and prognostic significance of PIK3CA mutations/amplifications in curative resected liposarcoma. Patients and methods A total of 125 liposarcoma tissue samples were collected over a 12-year period. PIK3CA mutations and gene copy number amplifications were analyzed by pyrosequencing and fluorescence in situ hybridization (FISH). Results Nine of the 105 liposarcomas (8.6%) had activating PIK3CA mutation. PIK3CA mutations were more frequent in myxoid/round cell and pleomorphic tumors compared with well-differentiated/dedifferentiated tumors (13.3% vs. 2.2%, P=0.043). In FISH PIK3CA analysis, copy number gain was detected in 14 of the 101 tumors (13.9%): 11 (10.9%) tumors had increased gene copy number (polysomy) and 3 (3.0%) exhibited gene amplification. In survival analysis, patients with PIK3CA copy number gain had a worse prognosis compared to patients without PIK3CA amplification (median disease-free survival [DFS] 22.2 vs. 107.6 months p=0.005). By multivariate analysis, PIK3CA copy number gain was an independent prognostic factor for worse DFS (P=0.027; hazard ratio, 2.400; 95% confidence interval 1.105 to 5.213). PIK3CA mutation was not associated with DFS and overall survival. Conclusions We demonstrated PIK3CA mutation and amplification in liposarcoma. PIK3CA copy number gain was an independent poor prognostic factor for DFS. Further studies are needed to evaluate the potential diagnostic and therapeutic role of PIK3CA mutations and amplifications in liposarcoma.
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Affiliation(s)
- Joo Hoon Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Seok Lee
- Department of Pathology, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Eo Jin Kim
- Department of Pathology, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Kyu Hyun Park
- Cancer Metastasis Research Center, Song Dang Institute for Cancer Research, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Hyang Kim
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Seong Yoon Yi
- Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Korea
| | - Han Seong Kim
- Department of Pathology, Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Korea
| | - Yong Jin Cho
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoo-Ho Shin
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Joong Bae Ahn
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuk Hu
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Sik Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Young Deuk Choi
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea
| | - Sunghoon Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Han Lee
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Suck Suh
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Hoon Noh
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Young Rha
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Song Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
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11
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Mascarenhas MRM, Mutti LDA, Paiva JMGD, Enokihara MMSES, Rosa IP, Enokihara MY. Giant atypical lipoma. An Bras Dermatol 2017; 92:546-549. [PMID: 28954109 PMCID: PMC5595607 DOI: 10.1590/abd1806-4841.20174447] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 07/13/2015] [Indexed: 11/22/2022] Open
Abstract
Liposarcomas correspond to the most common histological subtype of soft tissue sarcomas. They can be subdivided into: well differentiated or atypical lipoma, undifferentiated, myxoid, round, and pleomorphic cells. Atypical lipomas are the most prevalent and usually appear as asymptomatic softened tumors. They are locally aggressive but rarely lead to distant metastases. The diagnosis of this tumor is based on the imaging and histopathologic findings. Treatment consists of excision surgery with complete tumor removal. It has a good prognosis due to the low percentage of distant metastases. We report a rare case of giant atypical lipoma as well as the adopted therapy and evolution.
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Affiliation(s)
| | - Lais de Abreu Mutti
- Dermatology Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | | | | - Ival Peres Rosa
- Dermatology Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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12
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Lee H, Jo EB, Kim SJ, Yang HM, Kim YM, Sung YC, Park JB, Hong D, Park H, Choi YL, Kim SJ. Therapeutic strategies for locally recurrent and metastatic de-differentiated liposarcoma with herpes simplex virus-thymidine kinase-expressing mesenchymal stromal cells. Cytotherapy 2017; 19:1035-1047. [PMID: 28760351 DOI: 10.1016/j.jcyt.2017.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 04/24/2017] [Accepted: 05/18/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND AIMS Major challenges in de-differentiated liposarcoma (DDLPS) therapy are the high rate of sequential recurrence (>80%) and metastasis (20-30%) following surgical removal. However, well-defined therapeutic strategies for this rare malignancy are lacking and are critically needed. METHODS We investigated a new approach to DDLPS therapy with mesenchymal stromal cells expressing herpes simplex virus-thymidine kinase (MSC-TK). In an effort to evaluate this efficacy, in vitro cytotoxicity of MSC-TK against DDLPS cells was analyzed using an apoptosis assay. For pre-clinical study, the MSC-TK-induced reduction in recurrence and metastasis was validated in a recurrent DDLPS model after the macroscopic complete resection and lung metastasis DDLPS model. RESULTS MSC-TK induced apoptosis in DDLPS cells by bystander effects via gap junction intracellular communication (GJIC) of toxic ganciclovir (GCV). Recurrent DDLPS models following no residual tumor/microscopic tumor resection and lung metastasis DDLPS models were established, which suggested clinical relevance. MSC-TK markedly reduced locoregional recurrence rates and prolonged recurrence-free survival, thus increasing overall survival in the recurrent DDLPS model. MSC-TK followed by GCV treatment yielded a statistically significant reduction in early- and advanced-stage lung metastasis. DISCUSSION This therapeutic strategy may serve as an alternative or additional strategy by applying MSC-TK to target residual tumors following surgical resection, thus reducing local relapse and metastasis in these patients.
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Affiliation(s)
- Hyunjoo Lee
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea; Samsung Advanced Institute for Health Sciences and Technology, SungKyunKwan University, Seoul, Republic of Korea; Personalized Medicine, Children's Cancer Institute, Sydney, Australia
| | - Eun Byeol Jo
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea; Samsung Advanced Institute for Health Sciences and Technology, SungKyunKwan University, Seoul, Republic of Korea
| | - Su Jin Kim
- Department of Life Sciences, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Heung Mo Yang
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - You Min Kim
- Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea
| | - Young Chul Sung
- Department of Life Sciences, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Jae Berm Park
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea; Department of Surgery, Samsung Medical Center, Seoul, Republic of Korea
| | - Doopyo Hong
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Hyojun Park
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea; Department of Surgery, Samsung Medical Center, Seoul, Republic of Korea
| | - Yoon-La Choi
- Samsung Advanced Institute for Health Sciences and Technology, SungKyunKwan University, Seoul, Republic of Korea; Department of Pathology, Samsung Medical Center, Seoul, Republic of Korea.
| | - Sung Joo Kim
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea; Samsung Advanced Institute for Health Sciences and Technology, SungKyunKwan University, Seoul, Republic of Korea; Department of Surgery, Samsung Medical Center, Seoul, Republic of Korea.
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13
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Liverani C, La Manna F, Groenewoud A, Mercatali L, Van Der Pluijm G, Pieri F, Cavaliere D, De Vita A, Spadazzi C, Miserocchi G, Bongiovanni A, Recine F, Riva N, Amadori D, Tasciotti E, Snaar-Jagalska E, Ibrahim T. Innovative approaches to establish and characterize primary cultures: an ex vivo 3D system and the zebrafish model. Biol Open 2017; 6:133-140. [PMID: 27895047 PMCID: PMC5312106 DOI: 10.1242/bio.022483] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Patient-derived specimens are an invaluable resource to investigate tumor biology. However, in vivo studies on primary cultures are often limited by the small amount of material available, while conventional in vitro systems might alter the features and behavior that characterize cancer cells. We present our data obtained on primary dedifferentiated liposarcoma cells cultured in a 3D scaffold-based system and injected into a zebrafish model. Primary cells were characterized in vitro for their morphological features, sensitivity to drugs and biomarker expression, and in vivo for their engraftment and invasiveness abilities. The 3D culture showed a higher enrichment in cancer cells than the standard monolayer culture and a better preservation of liposarcoma-associated markers. We also successfully grafted primary cells into zebrafish, showing their local migratory and invasive abilities. Our work provides proof of concept of the ability of 3D cultures to maintain the original phenotype of ex vivo cells, and highlights the potential of the zebrafish model to provide a versatile in vivo system for studies with limited biological material. Such models could be used in translational research studies for biomolecular analyses, drug screenings and tumor aggressiveness assays.
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Affiliation(s)
- Chiara Liverani
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy
| | - Federico La Manna
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy.,Leiden University Medical Center, Department of Urology, J-3-100, Albinusdreef 2, Leiden 2333ZA, The Netherlands
| | - Arwin Groenewoud
- Department of Molecular Cell Biology, Institute of Biology, Leiden University, Sylviusweg 72, Leiden 2333BE, The Netherlands
| | - Laura Mercatali
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy
| | - Gabri Van Der Pluijm
- Leiden University Medical Center, Department of Urology, J-3-100, Albinusdreef 2, Leiden 2333ZA, The Netherlands
| | - Federica Pieri
- Pathology Unit, Morgagni-Pierantoni Hospital, Forlì 47121, Italy
| | - Davide Cavaliere
- Unit of Surgery and Advanced Oncologic Therapies, Morgagni-Pierantoni Hospital, Forlì 47121, Italy
| | - Alessandro De Vita
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy
| | - Chiara Spadazzi
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy
| | - Giacomo Miserocchi
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy
| | - Federica Recine
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy
| | - Nada Riva
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy
| | - Dino Amadori
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy
| | - Ennio Tasciotti
- Department of Regenerative Medicine, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, USA
| | - Ewa Snaar-Jagalska
- Department of Molecular Cell Biology, Institute of Biology, Leiden University, Sylviusweg 72, Leiden 2333BE, The Netherlands
| | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, via P. Maroncelli 40, Meldola 47014, Italy
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14
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Analysis of MDM2 Amplification in 43 Endometrial Stromal Tumors: A Potential Diagnostic Pitfall. Int J Gynecol Pathol 2016; 34:576-83. [PMID: 26444253 DOI: 10.1097/pgp.0000000000000187] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
MDM2 amplification is known to occur in a variety of neoplasms and its detection by fluorescence in situ hybridization is helpful in distinguishing well-differentiated and dedifferentated liposarcoma from classic lipoma. We recently evaluated a mesenteric mass initially diagnosed as dedifferentiated liposarcoma, largely due to the neoplasm's myxoid morphology and MDM2 expression by immunohistochemistry, from a 46-yr-old woman with a history of uterine low-grade endometrial stromal sarcoma (LG-ESS) with a JAZF1 rearrangement. Our workup of the mesenteric mass revealed a JAZF1 rearrangement and a revised diagnosis of metastatic LG-ESS with myxoid change was rendered. Retrospective testing of the mesenteric mass was negative for MDM2 amplification, an uncommon, but known diagnostic pitfall in MDM2 expression by immunohistochemistry. As MDM2 amplification is not specific for the diagnosis of liposarcoma, we investigated its occurrence in 43 cases of endometrial stromal tumors: 14 uterine LG-ESS, 11 metastatic or recurrent uterine LG-ESS, 8 undifferentiated uterine sarcomas, 5 endometrial stromal nodules, and 4 high-grade ESS with YHWAE rearrangement. In addition, 40 of the 43 cases had previously undergone fluorescence in situ hybridization analysis of JAZF1, PHF1, and YHWAE. Two of the 43 cases (5%) had MDM2 amplification: one was a uterine LG-ESS (JAZF1 rearrangement) and the other was a undifferentiated uterine sarcoma (polysomy intact JAZF1, PHF1, and YHWAE), both metastatic to the lung. Both cases positive for MDM2 amplification showed MDM2 expression by immunohistochemistry. At last follow-up, both patients had died of disease (19 and 60 mo). Our study is the first to demonstrate MDM2 amplification in endometrial stromal tumor. Awareness of MDM2 amplification in endometrial stromal tumor is critical; particularly in locations more common to liposarcoma, to avoid diagnostic errors.
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15
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Pham V, Henderson-Jackson E, Doepker MP, Caracciolo JT, Gonzalez RJ, Druta M, Ding Y, Bui MM. Practical Issues for Retroperitoneal Sarcoma. Cancer Control 2016; 23:249-64. [DOI: 10.1177/107327481602300308] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Retroperitoneal sarcoma is rare. Using initial specimens on biopsy, a definitive diagnosis of histological subtypes is ideal but not always achievable. Methods A retrospective institutional review was performed for all cases of adult retroperitoneal sarcoma from 1996 to 2015. A review of the literature was also performed related to the distribution of retroperitoneal sarcoma subtypes. A meta-analysis was performed. Results Liposarcoma is the most common subtype (45%), followed by leiomyosarcoma (21%), not otherwise specified (8%), and undifferentiated pleomorphic sarcoma (6%) by literature review. Data from Moffitt Cancer Center demonstrate the same general distribution for subtypes of retroperitoneal sarcoma. A pathology-based algorithm for the diagnosis of retroperitoneal sarcoma is illustrated, and common pitfalls in the pathology of retroperitoneal sarcoma are discussed. Conclusions An informative diagnosis of retroperitoneal sarcoma via specimens on biopsy is achievable and meaningful to guide effective therapy. A practical and multidisciplinary algorithm focused on the histopathology is helpful for the management of retroperitoneal sarcoma.
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Affiliation(s)
- Vicky Pham
- University of South Florida Morsani College of Medicine, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Evita Henderson-Jackson
- Departments of Anatomic Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
- Sarcoma, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Matthew P. Doepker
- Sarcoma, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
- Surgical Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Jamie T. Caracciolo
- Sarcoma, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
- Diagnostic Imaging, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Ricardo J. Gonzalez
- University of South Florida Morsani College of Medicine, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Mihaela Druta
- Sarcoma, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Yi Ding
- Department of Pathology, JiShuiTan Hospital, Beijing, China
| | - Marilyn M. Bui
- Departments of Anatomic Pathology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
- Sarcoma, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
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16
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Oh YJ, Yi SY, Kim KH, Cho YJ, Beum SH, Lee YH, Suh JS, Hur H, Kim KS, Kim SH, Choi YD, Shin KH, Jun HJ, Kim SJ, Lee J, Park SH, Noh SH, Rha SY, Kim HS. Prognostic Model to Predict Survival Outcome for Curatively Resected Liposarcoma: A Multi-Institutional Experience. J Cancer 2016; 7:1174-80. [PMID: 27326262 PMCID: PMC4911886 DOI: 10.7150/jca.15243] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/26/2016] [Indexed: 11/20/2022] Open
Abstract
Purpose: We performed this study to analyze the clinical features and prognosis of Korean patients with liposarcoma. Patients & Methods: Between October 1986 and April 2013, 231 patients who were diagnosed with liposarcoma by histologic examination were enrolled in this study. Results: The distribution of histologic subtypes was well-differentiated (n = 97, 42%), myxoid (n = 74, 32%), dedifferentiated (n = 32, 13.9%), pleomorphic (n = 15, 6.5%), and round-cell liposarcoma (n = 13, 5.6%). The majority of liposarcomas were located in the lower extremities (35.5%) and retroperitoneum (34.2%). Prognosis was worse for the trunk group compared with the extremity group (median disease-free survival [DFS] 3.3 vs. 9.9 years, respectively, P <0.001). Median DFS was significantly worse in patients with high grade histology compared to those with low grade histology (16.9% vs. 65.7%, P <0.001). The independent prognostic factors associated with survival were histology (hazard ratio [HR] 3.01; 95% confidence interval [CI], 1.82-4.97; P <0.001) and primary site (HR 1.80; 95% CI, 1.12-2.89; P = 0.015). Three risk groups with different survival outcomes were identified: group 1 (n = 98), no risk factors; group 2 (n = 92), one risk factor; and group 3 (n = 41), two risk factors. Conclusions: Histologic subtype and primary site were independent prognostic factors for curatively resected liposarcoma. A prognostic model for patients with liposarcoma clarified distinct groups of patients with good prognostic discrimination.
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Affiliation(s)
- Yoon Jung Oh
- 1. Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Yoon Yi
- 2. Division of Hematology-Oncology, Department of Internal Medicine, Inje University Ilsan Paik Hospital; Ilsan, Korea
| | - Ki Hyang Kim
- 3. Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Yong Jin Cho
- 4. Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Hoon Beum
- 5. Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Young Han Lee
- 6. Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Suck Suh
- 6. Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyuk Hur
- 7. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Sik Kim
- 7. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Hoon Kim
- 8. Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Deuk Choi
- 9. Department of Urology, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoo-Ho Shin
- 4. Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Jung Jun
- 10. Division of Medical Oncology & Hematology, Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
| | - Sung Joo Kim
- 11. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeeyun Lee
- 12. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Hoon Park
- 12. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Hoon Noh
- 7. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Young Rha
- 5. Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Song Kim
- 5. Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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17
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Surgical management of spinal liposarcoma: a case series of 7 patients and literature review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 25:4088-4093. [PMID: 26781842 DOI: 10.1007/s00586-015-4374-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 12/26/2015] [Accepted: 12/28/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Liposarcoma, one of the most common soft tissue sarcomas originates from primitive mesenchymal cells. But spinal involvement of either primary or metastatic liposarcoma is rare. Here we present our experience of seven consecutive patients with spinal liposarcoma. METHOD We retrospectively reviewed our patients who have spinal liposarcoma from January 2009 to December 2013. All patients were surgically treated at least once at our spine tumor center and be confirmed as liposarcoma after surgery. All patients' information and follow-up data were collected afterwards. RESULTS A total of six male and one female patients have been included. Five of them had mobile spinal involvement while the others had sacral involvement. Six piecemeal and one en-bloc resections were successfully performed. Patients' Frankel scores were upgraded with one level or at least preserved postoperatively. The average time of follow-up was 24.6 ± 13.9 months. Three patients died 13, 15 and 24 months after surgical treatment, respectively while the other four patients were still alive and one of them alive with disease at the end of follow-up. CONCLUSION The outcome and prognosis of spinal liposarcoma is poor, and surgical resections should be considered when diagnosis is confirmed. For those whose tumors were too large to resect and/or with multiple metastases, effective treatment options are currently limited. Therefore, multidisciplinary treatment should be adopted, intraoperative chemotherapy, systemic chemotherapy and radiotherapy for instance.
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18
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May CD, Garnett J, Ma X, Landers SM, Ingram DR, Demicco EG, Al Sannaa GA, Vu T, Han L, Zhang Y, Kivlin CM, Bolshakov S, Kalam AA, Liu J, Zhou F, Broccoli D, Wang WL, Lazar AJ, Pollock RE, Lev D, Torres KE. AXL is a potential therapeutic target in dedifferentiated and pleomorphic liposarcomas. BMC Cancer 2015; 15:901. [PMID: 26573603 PMCID: PMC4647521 DOI: 10.1186/s12885-015-1916-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 11/06/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AXL is a well-characterized, protumorigenic receptor tyrosine kinase that is highly expressed and activated in numerous human carcinomas and sarcomas, including aggressive subtypes of liposarcoma. However, the role of AXL in the pathogenesis of well-differentiated (WDLPS), dedifferentiated (DDLPS), and pleomorphic liposarcoma (PLS) has not yet been determined. METHODS Immunohistochemical analysis of AXL expression was conducted on two tissue microarrays containing patient WDLPS, DDLPS, and PLS samples. A panel of DDLPS and PLS cell lines were interrogated via western blot for AXL expression and activity and by ELISA for growth arrest-specific 6 (GAS6) production. AXL knockdown was achieved by siRNA or shRNA. The effects of AXL knockdown on cell proliferation, migration, and invasion were measured in vitro. In addition, AXL shRNA-containing DDLPS cells were assessed for their tumor-forming capacity in vivo. RESULTS In this study, we determined that AXL is expressed in a subset of WDLPS, DDLPS, and PLS patient tumor samples. In addition, AXL and its ligand GAS6 are expressed in a panel of DDLPS and PLS cell lines. We show that the in vitro activation of AXL via stimulation with exogenous GAS6 resulted in a significant increase in cell proliferation, migration, and invasion in DDLPS and PLS cell lines. Transient knockdown of AXL resulted in attenuation of these protumorigenic phenotypes in vitro. Stable AXL knockdown not only decreased migratory and invasive characteristics of DDLPS and PLS cells in vitro but also significantly diminished tumorigenicity of two dedifferentiated liposarcoma xenograft models in vivo. CONCLUSIONS Our results suggest that AXL signaling contributes to the aggressiveness of DDLPS and PLS, and that AXL is therefore a potential therapeutic target for treatment of these rare, yet devastating tumors.
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Affiliation(s)
- Caitlin D. May
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA ,The University of Texas Health Science Center at Houston Graduate School of Biomedical Sciences, Houston, TX USA
| | - Jeannine Garnett
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - XiaoYan Ma
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Sharon M. Landers
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Davis R. Ingram
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Elizabeth G. Demicco
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Ghadah A. Al Sannaa
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Tona Vu
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lixia Han
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA ,The University of Texas Health Science Center at Houston Graduate School of Biomedical Sciences, Houston, TX USA
| | - Yi Zhang
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Christine M. Kivlin
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA ,The University of Texas Health Science Center at Houston Graduate School of Biomedical Sciences, Houston, TX USA
| | - Svetlana Bolshakov
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Azad Abul Kalam
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Juehui Liu
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Fuguo Zhou
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Dominique Broccoli
- Curtis and Elizabeth Anderson Cancer Institute, Memorial University Medical Center, Savannah, GA USA
| | - Wei-Lien Wang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Alexander J. Lazar
- The University of Texas Health Science Center at Houston Graduate School of Biomedical Sciences, Houston, TX USA ,Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | | | - Dina Lev
- Department of Surgery, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Keila E. Torres
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA ,The University of Texas Health Science Center at Houston Graduate School of Biomedical Sciences, Houston, TX USA
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Peritoneal sarcomatosis: site of origin for the establishment of an in vitro and in vivo cell line model to study therapeutic resistance in dedifferentiated liposarcoma. Tumour Biol 2015; 37:2341-51. [DOI: 10.1007/s13277-015-4050-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 09/02/2015] [Indexed: 12/31/2022] Open
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Bill KLJ, Garnett J, Ma X, May C, Bolshakov S, Lazar AJ, Lev D, Pollock RE. The hepatocyte growth factor receptor as a potential therapeutic target for dedifferentiated liposarcoma. J Transl Med 2015; 95:951-61. [PMID: 26006023 PMCID: PMC4520775 DOI: 10.1038/labinvest.2015.62] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 11/25/2022] Open
Abstract
Dedifferentiated liposarcomas (DDLPS) are highly resistant to conventional chemo- and radiotherapies, with surgical resection remaining the classic treatment strategy; therefore, there is a pressing need for novel anti-DDLPS-targeted chemotherapeutics. Hepatocyte growth factor receptor (Met) expression is elevated in DDLPS, but the functional role of Met signaling in this disease is not known. We found that the in vitro stimulation of DDLPS cells with hepatocyte growth factor (HGF) elevated the degree of PI3K/AKT and MAPK pathway signaling, and that pro-tumorigenic phenotypes such as cell proliferation, invasion, and migration were significantly enhanced. Conversely, Met knockdown using shRNA-mediated interference decreased HGF-induced Met signaling, the invasive and migratory nature of DDLPS cells in vitro, and the tumorigenicity of DDLPS cells in vivo. These data strongly support the role for Met as a DDLPS therapeutic target. To that end, using EMD1214063, an ATP-competitive kinase inhibitor that targets Met more specifically than other kinases, inhibited Met-dependent signaling, reduced the oncogenicity of DDLPS cells in vitro, and significantly increased the survival of nude mice bearing subcutaneous DDLPS xenografts. These findings support further investigations of HGF-induced Met signaling inhibition in DDLPS, as a potential strategy to enhance clinical outcomes for this disease.
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Affiliation(s)
- Kate Lynn J. Bill
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA
- The University of Texas Graduate School of Biomedical Sciences, Houston, TX, USA
- The Sarcoma Research Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Surgical Oncology, Comprehensive Cancer Center, The Ohio State University (OSU), Columbus, OH, USA
| | - Jeannine Garnett
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA
- The Sarcoma Research Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xiaoyan Ma
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA
- The Sarcoma Research Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Caitlin May
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA
- The University of Texas Graduate School of Biomedical Sciences, Houston, TX, USA
- The Sarcoma Research Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Svetlana Bolshakov
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA
- The Sarcoma Research Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alexander J. Lazar
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA
- The Sarcoma Research Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Pathology, University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA
| | - Dina Lev
- Department of Surgery, The Sheba Medical Center, Tel Aviv, Israel
| | - Raphael E. Pollock
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center (MDACC), Houston, TX, USA
- The Sarcoma Research Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Surgical Oncology, Comprehensive Cancer Center, The Ohio State University (OSU), Columbus, OH, USA
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Vulvar Myxoid Liposarcoma and Well Differentiated Liposarcoma With Molecular Cytogenetic Confirmation. Int J Gynecol Pathol 2015; 34:390-5. [DOI: 10.1097/pgp.0000000000000170] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhou Y, Zhang Y, Huang Y, Tan R, Liu T, Zhuang R, Zhu M, Han W, Hou Y, Liu J, Zhang L, Jiang Y, Tong H, Shao Y, Zhu J, Lu W. Liposarcoma miRNA signatures identified from genome-wide miRNA expression profiling. Future Oncol 2015; 10:1373-86. [PMID: 25052748 DOI: 10.2217/fon.14.90] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIMS To identify the miRNA expression profile of liposarcoma (LPS) that could facilitate detection of LPS, and provide the basis for further investigation of molecular-targeted therapeutic drugs. MATERIALS & METHODS A real-time quantitative PCR assay was performed to analyze the expression of 1888 miRNAs from 25 LPS tumor tissue samples, 16 samples of adipose tissue adjacent to the tumors and 18 normal adipose tissue samples from patients with LPS. RESULTS Ten dysregulated miRNAs were identified that effectively distinguished LPS tissue from adipose tissue and benign lipoma tissue, and LPS tumor tissues from normal adipose tissues in LPS patients. Furthermore, the expression profiles of miRNAs could also classify the subtype of LPS. CONCLUSION The identified miRNAs appear to be novel biomarkers for the detection of LPS, and may contribute to an understanding of the mechanisms of LPS tumorigenesis and its development, and further elucidate the characteristics of LPS subtypes.
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Affiliation(s)
- Yuhong Zhou
- Department of Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
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Matthyssens LE, Creytens D, Ceelen WP. Retroperitoneal liposarcoma: current insights in diagnosis and treatment. Front Surg 2015; 2:4. [PMID: 25713799 PMCID: PMC4322543 DOI: 10.3389/fsurg.2015.00004] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 01/28/2015] [Indexed: 12/15/2022] Open
Abstract
Retroperitoneal liposarcoma (RLS) is a rare, biologically heterogeneous tumor that present considerable challenges due to its size and deep location. As a consequence, the majority of patients with high-grade RLS will develop locally recurrent disease following surgery, and this constitutes the cause of death in most patients. Here, we review current insights and controversies regarding histology, molecular biology, extent of surgery, (neo)adjuvant treatment, and systemic treatment including novel targeted agents in RLS.
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Affiliation(s)
| | - David Creytens
- Department of Pathology, Ghent University Hospital , Ghent , Belgium
| | - Wim P Ceelen
- Department of Surgery, Ghent University Hospital , Ghent , Belgium
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Analysis of the intratumoral adaptive immune response in well differentiated and dedifferentiated retroperitoneal liposarcoma. Sarcoma 2015; 2015:547460. [PMID: 25705114 PMCID: PMC4326351 DOI: 10.1155/2015/547460] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 01/07/2015] [Indexed: 01/08/2023] Open
Abstract
Treatment options are limited in well differentiated (WD) and dedifferentiated (DD) retroperitoneal liposarcoma. We sought to study the intratumoral adaptive immune response and explore the potential feasibility of immunotherapy in this disease. Tumor-infiltrating lymphocytes (TILs) were isolated from fresh surgical specimens and analyzed by flow cytometry for surface marker expression. Previously reported immune cell aggregates known as tertiary lymphoid structures (TLS) were further characterized by immunohistochemistry. In all fresh tumors, TILs were found. The majority of TILs were CD4 T cells; however cytotoxic CD8 T cells were also seen (average: 20% of CD3 T cells). Among CD8 T cells, 65% expressed the immune checkpoint molecule PD-1. Intratumoral TLS may be sites of antigen presentation as DC-LAMP positive, mature dendritic cells were found juxtaposed next to CD4 T cells. Clinicopathologic correlation, however, demonstrated that presence of TLS was associated with worse recurrence-free survival in WD disease and worse overall survival in DD disease. Our data suggest that an adaptive immune response is present in WD/DD retroperitoneal liposarcoma but may be hindered by TLS, among other possible microenvironmental factors; further investigation is needed. Immunotherapy, including immune checkpoint blockade, should be evaluated as a treatment option in this disease.
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Doria-Torra G, Martínez J, Domingo M, Vidaña B, Isidoro-Ayza M, Casanova MI, Vidal E. Liposarcoma in animals: literature review and case report in a domestic pig (Sus scrofa). J Vet Diagn Invest 2015; 27:196-202. [PMID: 25613042 DOI: 10.1177/1040638714567190] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Liposarcomas are malignant tumors of adipocytes. The current report describes a liposarcoma in a 2.5-year-old, mixed-breed commercial sow that was detected during meat inspection. On gross examination, a firm, whitish, multinodular, 20 cm ×10 cm mass was observed in the perirenal area along with smaller nodules multifocally scattered within the renal parenchyma. Histological examination revealed an anaplastic sarcoma with clear intracytoplasmic lipidic vacuoles that were positive for Sudan black staining. Most of the cells were also positive for S100 and vimentin immunohistochemistry. Based on these results, a diagnosis of a perirenal liposarcoma was established. To the authors' knowledge, no previous reports of liposarcomas in pigs have been published. This report also includes a review of the literature published on animal liposarcomas.
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Affiliation(s)
- Georgina Doria-Torra
- Departament de Sanitat i Anatomia Animals (Doria-Torra, Martínez, Domingo, Vidaña, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainServei de Diagnòstic de Patologia Veterinària (Doria-Torra, Martínez, Domingo, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainUniversitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, SpainCentre de Recerca en Sanitat Animal, UAB-IRTA, Bellaterra, Barcelona, Spain (Martínez, Domingo, Vidaña, Vidal)
| | - Jorge Martínez
- Departament de Sanitat i Anatomia Animals (Doria-Torra, Martínez, Domingo, Vidaña, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainServei de Diagnòstic de Patologia Veterinària (Doria-Torra, Martínez, Domingo, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainUniversitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, SpainCentre de Recerca en Sanitat Animal, UAB-IRTA, Bellaterra, Barcelona, Spain (Martínez, Domingo, Vidaña, Vidal)
| | - Mariano Domingo
- Departament de Sanitat i Anatomia Animals (Doria-Torra, Martínez, Domingo, Vidaña, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainServei de Diagnòstic de Patologia Veterinària (Doria-Torra, Martínez, Domingo, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainUniversitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, SpainCentre de Recerca en Sanitat Animal, UAB-IRTA, Bellaterra, Barcelona, Spain (Martínez, Domingo, Vidaña, Vidal)
| | - Beatriz Vidaña
- Departament de Sanitat i Anatomia Animals (Doria-Torra, Martínez, Domingo, Vidaña, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainServei de Diagnòstic de Patologia Veterinària (Doria-Torra, Martínez, Domingo, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainUniversitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, SpainCentre de Recerca en Sanitat Animal, UAB-IRTA, Bellaterra, Barcelona, Spain (Martínez, Domingo, Vidaña, Vidal)
| | - Marcos Isidoro-Ayza
- Departament de Sanitat i Anatomia Animals (Doria-Torra, Martínez, Domingo, Vidaña, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainServei de Diagnòstic de Patologia Veterinària (Doria-Torra, Martínez, Domingo, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainUniversitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, SpainCentre de Recerca en Sanitat Animal, UAB-IRTA, Bellaterra, Barcelona, Spain (Martínez, Domingo, Vidaña, Vidal)
| | - María Isabel Casanova
- Departament de Sanitat i Anatomia Animals (Doria-Torra, Martínez, Domingo, Vidaña, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainServei de Diagnòstic de Patologia Veterinària (Doria-Torra, Martínez, Domingo, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainUniversitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, SpainCentre de Recerca en Sanitat Animal, UAB-IRTA, Bellaterra, Barcelona, Spain (Martínez, Domingo, Vidaña, Vidal)
| | - Enric Vidal
- Departament de Sanitat i Anatomia Animals (Doria-Torra, Martínez, Domingo, Vidaña, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainServei de Diagnòstic de Patologia Veterinària (Doria-Torra, Martínez, Domingo, Isidoro-Ayza, Casanova), Bellaterra, Barcelona, SpainUniversitat Autònoma de Barcelona (UAB), Bellaterra, Barcelona, SpainCentre de Recerca en Sanitat Animal, UAB-IRTA, Bellaterra, Barcelona, Spain (Martínez, Domingo, Vidaña, Vidal)
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Pazopanib, a Receptor Tyrosine Kinase Inhibitor, Suppresses Tumor Growth through Angiogenesis in Dedifferentiated Liposarcoma Xenograft Models. Transl Oncol 2014; 7:665-71. [PMID: 25500074 PMCID: PMC4311036 DOI: 10.1016/j.tranon.2014.09.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 09/15/2014] [Accepted: 09/19/2014] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The rarity of dedifferentiated liposarcoma (DDLPS) and the lack of experimental DDLPS models limit the development of novel therapeutic strategies. Pazopanib (PAZ) is a tyrosine kinase inhibitor that is approved for the treatment of non-adipocytic advanced soft tissue sarcoma. The activity of this agent has not yet been properly explored in preclinical liposarcoma models nor in a randomized phase Ш clinical trial in this entity. The aim of the present study was to investigate whether PAZ had antitumor activity in DDLPS models in vivo. MATERIAL AND METHODS We established two patient-derived DDLPS xenograft models (UZLX-STS3 and UZLX-STS5) through implantation of tumor material from sarcoma patients in athymic nude NMRI mice. An animal model of the SW872 liposarcoma cell line was also used. To investigate the efficacy of PAZ in vivo, mice bearing tumors were treated for 2 weeks with sterile water, doxorubicin (1.2 mg/kg, intraperitoneally, twice per week), PAZ [40 mg/kg, orally (p.o.), twice per day], or PAZ plus doxorubicin (same schedules as for single treatments). RESULTS Patient-derived xenografts retained the histologic and molecular features of DDLPS. PAZ significantly delayed tumor growth by decreasing proliferation and inhibited angiogenesis in all models tested. Combining the angiogenesis inhibitor with an anthracycline did not show superior efficacy. CONCLUSION These results suggest that PAZ has potential antitumor activity in DDLPS primarily through antiangiogenic effects and therefore should be explored in clinical trials.
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CDK4 amplification predicts recurrence of well-differentiated liposarcoma of the abdomen. PLoS One 2014; 9:e99452. [PMID: 25121597 PMCID: PMC4133208 DOI: 10.1371/journal.pone.0099452] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 05/14/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The absence of CDK4 amplification in liposarcomas is associated with favorable prognosis. We aimed to identify the factors associated with tumor recurrence in patients with well-differentiated (WD) and dedifferentiated (DD) liposarcomas. METHODS From 2000 to 2010, surgical resections for 101 WD and DD liposarcomas were performed. Cases in which complete surgical resections with curative intent were carried out were selected. MDM2 and CDK4 gene amplification were analyzed by quantitative real-time polymerase chain reaction (Q-PCR). RESULTS There were 31 WD and 17 DD liposarcomas. Locoregional recurrence was observed in 11 WD and 3 DD liposarcomas. WD liposarcomas showed better patient survival compared to DD liposarcomas (P<0.05). Q-PCR analysis of the liposarcomas revealed the presence of CDK4 amplification in 44 cases (91.7%) and MDM2 amplification in 46 cases (95.8%). WD liposarcomas with recurrence after surgical resection had significantly higher levels of CDK4 amplification compared to those without recurrence (P = 0.041). High level of CDK4 amplification (cases with CDK4 amplification higher than the median 7.54) was associated with poor recurrence-free survival compared to low CDK4 amplification in both univariate (P = 0.012) and multivariate analyses (P = 0.020). CONCLUSIONS Level of CDK4 amplification determined by Q-PCR was associated with the recurrence of WD liposarcomas after surgical resection.
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Tseng WW, Madewell JE, Wei W, Somaiah N, Lazar AJ, Ghadimi MP, Hoffman A, Pisters PWT, Lev DC, Pollock RE. Locoregional disease patterns in well-differentiated and dedifferentiated retroperitoneal liposarcoma: implications for the extent of resection? Ann Surg Oncol 2014; 21:2136-43. [PMID: 24705628 DOI: 10.1245/s10434-014-3643-4] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Indexed: 02/03/2023]
Abstract
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.
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Affiliation(s)
- William W Tseng
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
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Rare myxoid liposarcoma metastasis to the interventricular septum of the heart. COR ET VASA 2014. [DOI: 10.1016/j.crvasa.2013.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Synergistic effects of targeted PI3K signaling inhibition and chemotherapy in liposarcoma. PLoS One 2014; 9:e93996. [PMID: 24695632 PMCID: PMC3973642 DOI: 10.1371/journal.pone.0093996] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 03/11/2014] [Indexed: 11/19/2022] Open
Abstract
While liposarcoma is the second most common soft tissue malignant tumor, the molecular pathogenesis in this malignancy is poorly understood. Our goal was therefore to expand the understanding of molecular mechanisms that drive liposarcoma and identify therapeutically-susceptible genetic alterations. We studied a cohort of high-grade liposarcomas and benign lipomas across multiple disease sites, as well as two liposarcoma cell lines, using multiplexed mutational analysis. Nucleic acids extracted from diagnostic patient tissue were simultaneously interrogated for 150 common mutations across 15 essential cancer genes using a clinically-validated platform for cancer genotyping. Western blot analysis was implemented to detect activation of downstream pathways. Liposarcoma cell lines were used to determine the effects of PI3K targeted drug treatment with or without chemotherapy. We identified mutations in the PIK3CA gene in 4 of 18 human liposarcoma patients (22%). No PIK3CA mutations were identified in benign lipomas. Western blot analysis confirmed downstream activation of AKT in both PIK3CA mutant and non-mutant liposarcoma samples. PI-103, a dual PI3K/mTOR inhibitor, effectively inhibited the activation of the PI3K/AKT in liposarcoma cell lines and induced apoptosis. Importantly, combination with PI-103 treatment strongly synergized the growth-inhibitory effects of the chemotherapy drugs doxorubicin and cisplatin in liposarcoma cells. Taken together, these findings suggest that activation of the PI3K/AKT pathway is an important cancer mechanism in liposarcoma. Targeting the PI3K/AKT/pathway with small molecule inhibitors in combination with chemotherapy could be exploited as a novel strategy in the treatment of liposarcoma.
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Braas D, Ahler E, Tam B, Nathanson D, Riedinger M, Benz MR, Smith KB, Eilber FC, Witte ON, Tap WD, Wu H, Christofk HR. Metabolomics strategy reveals subpopulation of liposarcomas sensitive to gemcitabine treatment. Cancer Discov 2013; 2:1109-17. [PMID: 23230188 DOI: 10.1158/2159-8290.cd-12-0197] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
UNLABELLED Unlike many cancers that exhibit glycolytic metabolism, high-grade liposarcomas often exhibit low 2[18F]fluoro-2-deoxy-D-glucose uptake by positron emission tomography (PET), despite rapid tumor growth. Here, we used liquid chromatography tandem mass spectrometry to identify carbon sources taken up by liposarcoma cell lines derived from xenograft tumors in patients. Interestingly, we found that liposarcoma cell lines consume nucleosides from culture media, suggesting nucleoside salvage pathway activity. The nucleoside salvage pathway is dependent on deoxycytidine kinase (dCK) and can be imaged in vivo by PET with 1-(2'-deoxy-2'-[18F]fluoroarabinofuranosyl) cytosine (FAC). We found that liposarcoma cell lines and xenograft tumors exhibit dCK activity and dCK-dependent FAC uptake in vitro and in vivo. In addition, liposarcoma cell lines and xenograft tumors are sensitive to treatment with the nucleoside analogue prodrug gemcitabine, and gemcitabine sensitivity is dependent on dCK expression. Elevated dCK activity is evident in 7 of 68 clinical liposarcoma samples analyzed. These data suggest that a subpopulation of liposarcoma patients have tumors with nucleoside salvage pathway activity that can be identified noninvasively using [18F]-FAC-PET and targeted using gemcitabine. SIGNIFICANCE Patients with high-grade liposarcoma have poor prognoses and often fail to respond to chemotherapy. This report identifies elevated nucleoside salvage activity in a subset of liposarcomas that are identifiable using noninvasive PET imaging with FAC and that are sensitive to gemcitabine. Thus, we suggest a new treatment paradigm for liposarcoma patients that uses [18F]-FAC-PET in the clinic to delineate gemcitabine responders from nonresponders.
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Affiliation(s)
- Daniel Braas
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California 90095, USA
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Tseng WW, Somaiah N, Lazar AJ, Lev DC, Pollock RE. Novel systemic therapies in advanced liposarcoma: a review of recent clinical trial results. Cancers (Basel) 2013; 5:529-49. [PMID: 24216990 PMCID: PMC3730323 DOI: 10.3390/cancers5020529] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 04/16/2013] [Accepted: 05/02/2013] [Indexed: 12/23/2022] Open
Abstract
Liposarcoma is one of the most common adult soft tissue sarcomas an consists of three histologic subtypes (well and dedifferentiated, myxoid/round cell, and pleomorphic). Surgery is the mainstay of treatment for localized disease; however for unresectable or metastatic disease, effective treatment options are currently limited. In the past decade, a better understanding of the distinct genetic and molecular aberrations for each of the three histologic subtypes has led to the development of several novel systemic therapies. Data from phase I and early phase II clinical trials have been reported. Despite challenges with conducting clinical trials in liposarcoma, preliminary results for several of these novel, biology-driven therapies are encouraging.
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Affiliation(s)
- William W. Tseng
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
| | - Neeta Somaiah
- Department of Sarcoma Medical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
| | - Alexander J. Lazar
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
| | - Dina C. Lev
- Department of Cancer Biology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
| | - Raphael E. Pollock
- Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
- Department of Cancer Biology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-713-792-6928; Fax: +1-713-563-4637
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Metastatic liposarcoma of the heart. Case series and brief literature review. Herz 2013; 38:938-42. [PMID: 23436031 DOI: 10.1007/s00059-013-3768-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 01/22/2013] [Accepted: 01/24/2013] [Indexed: 10/27/2022]
Abstract
Secondary cardiac tumors are 20-40 times more frequent than primary lesions. Primary cardiac lesions are represented by myxomas when related to benign tumors, and by sarcomas in terms of malignant disease. Metastases to the heart from liposarcomas are very rare. We present three cases of secondary liposarcomas involving the left atrium, the right atrium, and the pericardium.
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Abstract
The rapid growth of tissue-based molecular pathology has changed the practice of the surgical pathologist signing out soft tissue tumors. This information is presented in a practical and succinct manner focusing on clinically validated findings that have diagnostic or therapeutic relevance. The approach is morphologically based and focuses on differential diagnoses and clinical scenarios. Molecular techniques can be an invaluable ancillary tool.
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Affiliation(s)
- Robin D LeGallo
- Department of Pathology, University of Virginia Health System, 1215 Lee Street, HEP 3064, Charlottesville, VA 22908, USA.
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Seishima R, Ishii Y, Hasegawa H, Endo T, Ochiai H, Okabayashi K, Mukai M, Kitagawa Y. Large liposarcoma developing in the ischiorectal fossa: Report of a rare case. Int J Surg Case Rep 2012; 4:51-3. [PMID: 23123415 DOI: 10.1016/j.ijscr.2012.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 09/24/2012] [Accepted: 09/25/2012] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION We herein report an extremely rare case of a liposarcoma developing in the ischiorectal fossa that was completely resected using a transsacral approach. PRESENTATION OF CASE A 74-year-old man was admitted to our institute because of a large perianal tumor. A pelvic magnetic resonance imaging (MRI) revealed an 8cm×7cm×5cm sized encapsulated heterogeneous tumor on the right side of the ischiorectal fossa. Transsacral excision was performed under a diagnosis of liposarcoma. The tumor was partially fixed to the external sphincter and puborectalis. Therefore, the muscles were partially resected to ensure sufficient margins. Histopathological examination revealed a well differentiated liposarcoma and negative surgical margins. DISCUSSION The basic treatment strategy of liposarcoma is surgical resection, whereas the effects of chemotherapy or radiotherapy remain limited. Although no postoperative adjuvant therapy has been performed in our case, no recurrences have occurred for 1 year after surgery. CONCLUSION Although the curative resection of large tumors located in the ischiorectal fossa is usually difficult, the complete resection of liposarcoma is the main potentially curative treatment. A transsacral approach is useful for a complete resection.
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Affiliation(s)
- Ryo Seishima
- Department of Surgery, Keio University School of Medicine, Japan.
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Meltzer PS, Helman LJ. Genomic Investigation of Dedifferentiated Liposarcoma Suggests a Role for Therapeutic Targeting of the Tumor Epigenome. Cancer Discov 2011; 1:555-6. [DOI: 10.1158/2159-8290.cd-11-0291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ghadimi MP, Al-Zaid T, Madewell J, Peng T, Colombo C, Hoffman A, Creighton CJ, Zhang Y, Zhang A, Lazar AJ, Pollock RE, Lev D. Diagnosis, Management, and Outcome of Patients with Dedifferentiated Liposarcoma Systemic Metastasis. Ann Surg Oncol 2011; 18:3762-70. [DOI: 10.1245/s10434-011-1794-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Indexed: 01/06/2023]
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