1
|
Ren L, Qi Y, Zhao J, Weng C, Wang J, Yuan D, Wang T. Gender Differences in Prognosis After Primary Resection for Retroperitoneal Liposarcoma. Am Surg 2024; 90:575-584. [PMID: 37728273 DOI: 10.1177/00031348231201883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND Current evidence regarding gender difference in retroperitoneal liposarcoma (RLPS) is scarce, so we sought to investigate whether gender may affect prognosis after primary resection of RLPS. METHODS We used the Surveillance, Epidemiology, and End Results (SEER) database to identify RLPS patients from January 1973 to December 2015. Multivariate cox proportional hazard analysis was adopted to generate adjusted hazard ratio (AHR) and 95% confidence intervals (CIs) of survival outcomes. RESULTS In total, 2108 RLPS patients, including 971 women and 1137 men, were identified, with a median follow-up of 45.0 (17.0-92.0) months. The 5-year and 10-year overall survival rates were 50.5% and 31.5% for men and 60.4% and 42.5% for women. The 5-year and 10-year disease-specific survival rates for men and women were 71.5%, 57.3% and 76.3%, 62.1%, respectively. We found men were associated with an increased risk of all-cause mortality (AHR 1.3, 95% CI 1.0-1.6, P = .017) but not disease-specific mortality (AHR 1.2, 95% CI .9-1.6, P = .246). The subgroup analyses revealed that men were associated with an increased risk of all-cause mortality in patients with low-grade tumors (AHR 1.8, 95% CI 1.3-2.5) or patients who received non-radical resection (AHR 1.6, 95% CI 1.2-2.1). In the subgroup of low-grade tumors, men were also associated with an increased risk of disease-specific mortality (AHR 2.0, 95% CI 1.2-3.3). CONCLUSION Men may have worse survival after primary resection of RLPS compared with women, especially in patients with low-grade tumors or patients who received non-radical resection. Gender-based disparities may deserve more attention in patients with RLPS.
Collapse
Affiliation(s)
- Li Ren
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yuhan Qi
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jichun Zhao
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Chengxin Weng
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jiarong Wang
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ding Yuan
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Tiehao Wang
- Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
2
|
Shi X, Guo H, Zhu C, Qiu G, Liang T, Lian J, Ma Y, Wang S, Li X. Mixed reality in primary retroperitoneal tumour surgery: Evaluation of preoperative and intraoperative application value. Int J Med Robot 2023:e2584. [PMID: 37792998 DOI: 10.1002/rcs.2584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/06/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE To evaluate the feasibility and application value of mixed reality technology (MR) in Primary retroperitoneal tumour (PRT) surgery. METHODS From 276 patients who underwent PRT resection at the First Affiliated Hospital of Xi'an Jiaotong University, we screened 46 patients who underwent MR-assisted retroperitoneal tumour resection and 46 patients who underwent tumour resection without MR assistance. The intraoperative and postoperative recovery of the patients in both groups were compared, and the reliability and validity of the application of MR were further examined using the Likert scale. RESULTS There was a significant difference in the mean intraoperative bleeding volume between the two groups, but it was reduced in the MR group. The results of the Likert scale showed higher scores in the MR group than non-MR group. CONCLUSIONS MR can be used to assist PRT resection and has great potential to improve the rate of complete retroperitoneal tumour resection.
Collapse
Affiliation(s)
- Xiaoqiang Shi
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hainan Guo
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chao Zhu
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of General Surgery, The People's Hospital of Suide County, Suide, Shaanxi, China
| | - Guanglin Qiu
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ting Liang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Biomedical Engineering, the Key Laboratory of Biomedical Information Engineering of the Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jie Lian
- Department of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yanfei Ma
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Second Department of General Surgery, The Suide Campus, The First Hospital of Yulin, Yulin, Shaanxi, China
| | - Shufeng Wang
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xuqi Li
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| |
Collapse
|
3
|
Liveringhouse CL, Palm RF, Bryant JM, Yang GQ, Mills MN, Figura ND, Ahmed KA, Mullinax J, Gonzalez R, Johnstone PA, Naghavi AO. Neoadjuvant Simultaneous Integrated Boost Radiation Therapy Improves Clinical Outcomes for Retroperitoneal Sarcoma. Int J Radiat Oncol Biol Phys 2023; 117:123-138. [PMID: 36935026 DOI: 10.1016/j.ijrobp.2023.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/24/2023] [Accepted: 03/02/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE Neoadjuvant radiation therapy (RT) with standard techniques (ST) offers a modest benefit in retroperitoneal sarcoma (RPS). As the high-risk region (HRR) at risk for a positive surgical margin and recurrence is posterior and away from radiosensitive organs at risk, using a simultaneous integrated boost (SIB) allows targeted dose escalation to the HRR while sparing these organs. We hypothesized that neoadjuvant SIB RT can improve disease control compared with ST, without increasing toxicity. METHODS AND MATERIALS We retrospectively identified patients with resectable nonmetastatic RPS from 2000 to 2021 who received neoadjuvant RT of 180 to 200 cGy/fraction to standard volumes. SIB patients received 205 to 230 cGy/fraction to the appropriate HRR. Clinical endpoints included abdominopelvic control (APC), recurrence-free survival (RFS), overall survival (OS), and acute toxicity. RESULTS With a median follow-up of 57 months (95% confidence interval [CI], 50-64), there were 103 patients with RPS who received either ST (n = 69) or SIB (n = 34) RT. Median standard volume dose was 5000 cGy (ST) and 4500 cGy (SIB), with a median HRR SIB dose of 5750 cGy. Liposarcomas (79% vs 53%; P = .004) and cT4 tumors (59% vs 19%; P < .001) were more common in the SIB cohort, without a significant difference in the rate of resection (82% vs 81%; P = .88) or R1 margin (53.5% vs 50%; P = .36); there were no R2 resections. SIB was associated with a significant improvement in 5-year APC (96% vs 70%; P = .046) and RFS (60.2% vs 36.3%; P = .036), with a nonsignificant OS difference (90.1% vs 67.5%; P = .164). On multivariable analysis, SIB remained a predictor for APC (hazard ratio, 0.07; 95% CI, 0.01-0.74; P = .027) and RFS (hazard ratio, 0.036; 95% CI, 0.13-0.98; P = .045). SIB showed no significant detriment in toxicity, albeit with a lower rate of overall grade 3 acute toxicity (3% vs 22%; P = .023) compared with ST. CONCLUSIONS In RPS, dose escalation with neoadjuvant SIB RT may be independently associated with improved APC and RFS, without a detriment in toxicity, compared with ST. With the addition of standard RT having only a modest benefit compared with surgery alone, our study suggests that future prospective studies evaluating for the benefit of SIB RT should be considered.
Collapse
Affiliation(s)
- Casey L Liveringhouse
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Russell F Palm
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - John M Bryant
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - George Q Yang
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Matthew N Mills
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Nicholas D Figura
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kamran A Ahmed
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - John Mullinax
- Sarcoma Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Ricardo Gonzalez
- Sarcoma Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Peter A Johnstone
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Arash O Naghavi
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
| |
Collapse
|
4
|
Which modality is better to diagnose high-grade transformation in retroperitoneal liposarcoma? Comparison of computed tomography, positron emission tomography, and magnetic resonance imaging. Int J Clin Oncol 2023; 28:482-490. [PMID: 36583836 DOI: 10.1007/s10147-022-02287-6] [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: 09/05/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Survival in patients with retroperitoneal liposarcoma (RPLS) depends on the surgical management of the dedifferentiated foci. The present study investigated the diagnostic yield of contrast-enhanced CT, 18F-fluorodeoxyglucose positron emission tomography (PET), and diffusion-weighted MRI in terms of dedifferentiated foci within the RPLS. METHODS Patients treated with primary or recurrent RPLS who underwent the above imaging between January 2010 and December 2021 were retrospectively reviewed. The diagnostic accuracy of the three modalities for histologic subtype of dedifferentiated liposarcoma (DDLS) and French Federation of Cancer Center (FNCLCC) grade 2/3 were compared using receiver operating characteristic curves and areas under the curves (AUCs). RESULTS The cohort involved 32 patients with 53 tumors; 30 of which exhibited DDLS and 31 of which did FNCLCC grades 2/3. The optimal thresholds for predicting DDLS were mean CT value of 31 Hounsfield Unit (HU) (AUC = 0.880, 95% CI 0.775-0.984; p < 0.001), maximum standardized uptake value (SUVmax) of 2.9 (AUC = 0.865 95% CI 0.792-0.980; p < 0.001), while MRI failed to differentiate DDLS. The cutoff values for distinguishing FNCLCC grades 1 and 2/3 were a mean CT value of 24 HU (AUC = 0.858, 95% CI 0.731-0.985; p < 0.001) and SUVmax of 2.9 (AUC = 0.885, 95% CI 0.792-0.978; p < 0.001). MRI had no sufficient power to separate these grades. CONCLUSIONS Contrast-enhanced CT and PET were useful for predicting DDLS and FNCLCC grade 2/3, while MRI was inferior to these two modalities.
Collapse
|
5
|
Bianchi A, Pagan-Pomar A, Ramos-Asensio R, Luna-Fra P, Jiménez-Segovia M, Pujol-Cano N, Ochogavia-Seguí A, Martínez-Corcoles JA, González-Argenté FX. Analysis of potential risk factors in the survival of patients with primary retroperitoneal liposarcoma. Cir Esp 2022; 100:691-701. [PMID: 36270703 DOI: 10.1016/j.cireng.2022.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 07/29/2021] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The present work is an observational study of a series of variables regarding overall survival and disease-free survival in patients diagnosed with primary liposarcoma. METHODS The study is prospective with retrolective data collection that includes all patients with primary liposarcoma referred to Hospital Son Espases University Hospital, Palma de Mallorca, Spain from January 1990 to December 2019. RESULTS The study includes 50 patients and the compartment surgery was performed in 18 patients (36%) of cases. The mean overall survival of the sample was 15.57 years (95% CI: 12.02-19.12) and the mean disease-free survival was 6.70 years (95% CI: 4.50-8.86). CONCLUSION Compartment surgery has not shown benefits in terms of overall survival and disease-free survival. The ASA classification (≥3) predicts a poor prognosis in both overall survival and disease-free survival. Resection with free margins, described on the pathological results and defined in this work as R0, show better disease-free survival.
Collapse
Affiliation(s)
- Alessandro Bianchi
- Department of General Surgery, Universitary Hospital Son Espases, Palma de Mallorca, Spain.
| | - Alberto Pagan-Pomar
- Department of General Surgery, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | - Rafael Ramos-Asensio
- Department of Pathological Anatomy, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | - Pablo Luna-Fra
- Department of Oncology, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | - Marina Jiménez-Segovia
- Department of General Surgery, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | - Natalia Pujol-Cano
- Department of General Surgery, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | - Aina Ochogavia-Seguí
- Department of General Surgery, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | | | | |
Collapse
|
6
|
Lee JS, Kelly CM, Bartlett EK. Management of pelvic sarcoma. Eur J Surg Oncol 2022; 48:2299-2307. [PMID: 36195471 DOI: 10.1016/j.ejso.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/07/2022] [Accepted: 09/14/2022] [Indexed: 10/14/2022] Open
Abstract
Pelvic sarcomas are a rare and heterogenous group of tumors divided into two groups: soft tissue sarcomas and bone sarcomas. Soft tissue sarcomas of the pelvis include most commonly liposarcoma, leiomyosarcoma, gastrointestinal stromal tumors, malignant peripheral nerve sheath tumors, and solitary fibrous tumors. Bone sarcomas of the pelvis most commonly include osteosarcoma and chondrosarcoma. Multidisciplinary treatment at a center experienced in the treatment of sarcoma is essential. Management is dictated by histologic type and grade. Surgical resection with wide margins is the cornerstone of treatment for pelvic sarcomas, although this is often challenging due to anatomic constraints of the pelvis. Multimodal treatment is critical due to the high risk of local recurrence in the pelvis.
Collapse
Affiliation(s)
- Jay S Lee
- Department of Surgery, Duke University, Durham, NC, USA
| | - Ciara M Kelly
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Edmund K Bartlett
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| |
Collapse
|
7
|
Wang Z, Wu JH, Li CP, Lv A, Qiu H, Tian XY, Liu BN, Hao CY. Patients with first recurrent retroperitoneal sarcoma that can be macroscopically completely resected can achieve comparable outcomes with that of primary patients after en bloc resection of tumor and adjacent organs. Front Surg 2022; 9:956384. [PMID: 36157408 PMCID: PMC9489918 DOI: 10.3389/fsurg.2022.956384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/19/2022] [Indexed: 11/18/2022] Open
Abstract
The outcomes of patients with primary retroperitoneal sarcoma (RPS) are significantly superior to those with recurrence. En bloc resection of tumor and adjacent organs is recommended in primary RPS. However, whether en bloc resection of tumor and adjacent organs can benefit recurrent patients or some recurrent patients is unclear. We compared the outcomes of patients with primary RPS, first recurrence (RPS-Rec1), and ≥2 recurrences (≥RPS-Rec2) to evaluate the value and criteria for en bloc resection of tumor and adjacent organs in recurrent cases. We evaluated the safety of en bloc resection of tumor and adjacent organs by assessing operation time, blood loss volume, postoperative morbidities (POM), and efficacy by comparing local recurrence and peritoneal metastasis (LR-PM), distant metastasis, progression-free survival (PFS), and overall survival (OS). A total of 101, 47, and 30 patients with primary RPS, RPS-Rec1, and ≥RPS-Rec2 were included, respectively. Recurrent RPS invaded more adjacent organs and surrounding fat tissue than primary RPS. The operation time, amount of blood loss, incidence of grade III–V POM, LR-PM rate, PFS, and OS in the RPS-Rec1 group were similar to those of the primary group, both of which were significantly superior to those of the ≥RPS-Rec2 group. Macroscopically incomplete resection and high-grade RPS rather than first recurrence were independent risk factors for LR-PM, PFS, and OS. In conclusion, the safety and efficacy of en bloc resection of tumor and adjacent organs in RPS-Rec1 were comparable with those in primary RPS but significantly superior to those of ≥RPS-Rec2. For RPS-Rec1, comparable outcomes to patients with primary RPS can be achieved, particularly in those in whom a macroscopically complete resection is achieved.
Collapse
|
8
|
Paik B, Seo CJ, Tan JWS, Juan WKD, Soo KC, Ong CAJ, Chia CS, Wong JSM. A systematic review of margin status in retroperitoneal liposarcomas: Does the R0 margin matter? Front Oncol 2022; 12:891710. [PMID: 36033535 PMCID: PMC9404241 DOI: 10.3389/fonc.2022.891710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Retroperitoneal liposarcomas (RPLPSs) are a rare tumor group for which current guidelines recommend aggressive en bloc resection to attain microscopically negative (R0) margins. To ensure R0 margins, resection of adherent or adjacent organs is often required. However, it is still unclear if R0 margins confer any additional benefit to patients over a grossly negative but microscopically positive (R1) margin. We performed a systematic search of PubMed and Embase databases for studies including patients receiving R0 or R1 resection for RPLPS. Nine retrospective cohort studies, one prospective cohort study, and 49 case reports/case series were included. A total of 552 patients with RPLPS were evaluated: 346 underwent R0 resection and 206 underwent R1 resection. In the R0 group, 5-year overall survival (OS) ranged from 58.3% to 85.7%; local recurrence (LR) ranged from 45.5% to 52.3%. In the R1 group, 5-year OS ranged from 35% to 55.3%; LR ranged from 66.7% to 91.7%. Among cohort studies, OS, disease-free survival (DFS), LR rate, and LR-free survival (LRFS) were significantly associated with R0 resections. Assessment of case series and reports suggested that the R0 margin led to a slightly higher morbidity than that of R1. In conclusion, this review found the R0 margin to be associated with reductions in LR rates and improved OS when compared with the R1 margins, though accompanied by slight increases in morbidity. The roles of tumor histotype and perioperative chemotherapy or radiotherapy were not well-elucidated in this review.
Collapse
Affiliation(s)
- Benjamin Paik
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Chin Jin Seo
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- Sing Health Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Joey Wee-Shan Tan
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- Laboratory of Applied Human GenetiCJS, Division of Medical Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Wen Kai Darryl Juan
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
| | - Khee Chee Soo
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
| | - Chin-Ann Johnny Ong
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- Sing Health Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Laboratory of Applied Human GenetiCJS, Division of Medical Sciences, National Cancer Centre Singapore, Singapore, Singapore
- Sing Health Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Institute of Molecular and Cell Biology, ASTAR Research Entities, Singapore, Singapore
| | - Claramae Shulyn Chia
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- Sing Health Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Sing Health Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Jolene Si Min Wong
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore, Singapore
- Sing Health Duke-NUS Surgery Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Sing Health Duke-NUS Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- *Correspondence: Jolene Si Min Wong, j
| |
Collapse
|
9
|
Retroperitoneal Sarcomas: Histology Is Everything. Surg Clin North Am 2022; 102:601-614. [PMID: 35952690 DOI: 10.1016/j.suc.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Retroperitoneal sarcomas (RPS) are a rare subset of soft tissue sarcoma that are composed of only a few histologic subtypes, each with a distinct tumor biology, clinical presentation, preferred treatment strategy, recurrence risk, and surveillance plan. In the modern era of precision medicine, our understanding of the implications of subtype tumor biology and anatomic location has led to a more nuanced, histology-specific approach to therapy, including surgery, neoadjuvant radiation therapy, and/or chemotherapy. This article provides a summary of recent updates to the management of RPS.
Collapse
|
10
|
Zhuang A, Lu W, Fang Y, Ma L, Xu J, Wang J, Tong H, Zhang Y. Prognostic Factors and Nomogram Construction for First Local Recurrent Retroperitoneal Sarcoma Following Surgical Resection: A Single Asian Cohort of 169 Cases. Front Oncol 2022; 12:856754. [PMID: 35480122 PMCID: PMC9035871 DOI: 10.3389/fonc.2022.856754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This study aimed to explore the prognostic factors for first local recurrent retroperitoneal soft tissue sarcoma (FLR-RPS) and construct predictive nomograms in the Asian population. Methods In a single Asian sarcoma center, data of patients with FLR-RPS were retrospectively analyzed from January 2011 to September 2020. We developed and internally validated prognostic factors determined by the Cox regression model, as well as nomograms for predicting recurrence-free survival (RFS) and overall survival (OS). The concordance index and calibration curve were used to determine the nomogram’s discriminative and predictive ability. Results With 169 patients, the median follow-up duration was 48 months and the 5-year OS rate was 60.9% (95% confidence interval (CI), 51.9%–69.9%). OS was correlated with chemotherapy at the time of initial surgery and tumor grading. The 5-year cumulative local recurrence rate and distant metastasis rate were 75.9% (95% CI, 67.5%–84.3%) and 10.1% (95% CI, 4.2%–16.0%), respectively, and the length of the disease-free interval following the primary operation was associated with disease recurrence. The 6-year OS and cumulative recurrence rate after surgery in our cohort were comparable with those in the TARPSWG cohort, but the proportion of local recurrence was higher (80.4% vs. 59.0%), and distant metastasis was less common (10.1% vs. 14.6%). In this study, two nomogram prediction models were established, which could predict the 1-, 2-, and 5-year OS and RFS, and the concordance indices were 0.74 and 0.70, respectively. The calibration plots were excellent. Conclusions For the FLR-RPS patients, some can still achieve an ideal prognosis. The treatment of FLR-RPS in Asian populations can be aided by the predictive model established in this study.
Collapse
Affiliation(s)
- Aobo Zhuang
- Department of General Surgery, South Hospital of the Zhongshan Hospital/Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Weiqi Lu
- Department of General Surgery, South Hospital of the Zhongshan Hospital/Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuan Fang
- Department of General Surgery, South Hospital of the Zhongshan Hospital/Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Lijie Ma
- Department of General Surgery, South Hospital of the Zhongshan Hospital/Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jing Xu
- Department of General Surgery, South Hospital of the Zhongshan Hospital/Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jiongyuan Wang
- Department of General Surgery, South Hospital of the Zhongshan Hospital/Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hanxing Tong
- Department of General Surgery, South Hospital of the Zhongshan Hospital/Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- *Correspondence: Yong Zhang, ; Hanxing Tong,
| | - Yong Zhang
- Department of General Surgery, South Hospital of the Zhongshan Hospital/Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- *Correspondence: Yong Zhang, ; Hanxing Tong,
| |
Collapse
|
11
|
Comparison of preoperative chemoradiation with radiation or chemotherapy alone in patients with non-metastatic, resectable retroperitoneal sarcoma. JOURNAL OF RADIOTHERAPY IN PRACTICE 2021. [DOI: 10.1017/s1460396921000480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Aim:
Optimal preoperative therapy regimen in the treatment of resectable retroperitoneal sarcoma (RPS) remains unclear. This study compares the impact of preoperative radiation, chemoradiation and chemotherapy on overall survival (OS) in RPS patients.
Materials and Methods:
The National Cancer Database (NCDB) was queried for patients with non-metastatic, resectable RPS (2006–15). The primary endpoint was OS, evaluated by Kaplan–Meier method, log-rank test, Cox multivariable analysis and propensity score matching.
Results:
A total of 1,253 patients met the inclusion criteria, with 210 patients (17%) receiving chemoradiation, 850 patients (68%) receiving radiation and 193 patients (15%) receiving chemotherapy. On Cox multivariable analysis, when compared to preoperative chemoradiation, preoperative radiation was not associated with improved OS (hazards ratio [HR] 0·98, 95% CI 0·76–1·25, p = 0·84), while preoperative chemotherapy was associated with worse OS (HR 1·64, 95% CI 1·24–2·18, p < 0·001). Similar findings were observed in 199 and 128 matched pairs for preoperative radiation and chemotherapy, respectively, when compared to preoperative chemoradiation.
Findings:
Our study suggested an OS benefit in using preoperative chemoradiation compared to chemotherapy alone, but OS outcomes were comparable between preoperative chemoradiation and radiation alone.
Collapse
|
12
|
Bianchi A, Pagan-Pomar A, Ramos-Asensio R, Luna-Fra P, Jiménez-Segovia M, Pujol-Cano N, Ochogavia-Seguí A, Martínez-Corcoles JA, González-Argenté FX. Analysis of potential risk factors in the survival of patients with primary retroperitoneal liposarcoma. Cir Esp 2021; 100:S0009-739X(21)00253-0. [PMID: 34507818 DOI: 10.1016/j.ciresp.2021.07.009] [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: 01/16/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The present work is an observational study of a series of variables regarding overall survival and disease-free survival in patients diagnosed with primary liposarcoma. METHODS The study is prospective with retrolective data collection that includes all patients with primary liposarcoma referred to Hospital Son Espases University Hospital, Palma de Mallorca, Spain from January 1990 to December 2019. RESULTS The study includes 50 patients and the compartment surgery was performed in 18 patients (36%) of cases. The mean overall survival of the sample was 15.57 years (95% CI: 12.02-19.12) and the mean disease-free survival was 6.70 years (95% CI: 4.50-8.86). CONCLUSION Compartment surgery has not shown benefits in terms of overall survival and disease-free survival. The ASA classification (≥3) predicts a poor prognosis in both overall survival and disease-free survival. Resection with free margins, described on the pathological results and defined in this work as R0, show better disease-free survival.
Collapse
Affiliation(s)
- Alessandro Bianchi
- Department of General Surgery, Universitary Hospital Son Espases, Palma de Mallorca, Spain.
| | - Alberto Pagan-Pomar
- Department of General Surgery, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | - Rafael Ramos-Asensio
- Department of Pathological Anatomy, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | - Pablo Luna-Fra
- Department of Oncology, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | - Marina Jiménez-Segovia
- Department of General Surgery, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | - Natalia Pujol-Cano
- Department of General Surgery, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | - Aina Ochogavia-Seguí
- Department of General Surgery, Universitary Hospital Son Espases, Palma de Mallorca, Spain
| | | | | |
Collapse
|
13
|
Ushida Y, Ito H, Inoue Y, Sato T, Ono Y, Oba A, Takahashi Y. Liposarcoma of gallbladder: a case report and literature review. J Surg Case Rep 2021; 2021:rjab273. [PMID: 34168860 PMCID: PMC8219400 DOI: 10.1093/jscr/rjab273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/01/2021] [Indexed: 11/24/2022] Open
Abstract
A 53-year-old man with prior history of resection of liposarcoma in his leg presented with gallbladder mass. Computed tomography showed 4-cm tumor at gallbladder fundus with weak enhancement with IV contrast. Differential diagnoses included hemangioma and liposarcoma, and laparoscopic cholecystectomy was recommended. In the operating room, the tumor appeared without serosal and liver invasions and uncomplicated laparoscopic cholecystectomy was completed. Histopathological examination revealed the tumor as myxoid liposarcoma with round cells. Adjuvant chemotherapy was not given, and he was placed on imaging surveillance. At 16 months after the operation, he developed recurrence of liposarcoma in the left popliteal fossa.
Collapse
Affiliation(s)
- Yuta Ushida
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| | - Hiromichi Ito
- Correspondence address. Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan. Tel: +81-3-3520-6111; Fax: +81-3-3570-0343; E-mail:
| | - Yosuke Inoue
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| | - Takafumi Sato
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| | - Yoshihiro Ono
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| | - Atsushi Oba
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| | - Yu Takahashi
- Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135-8550, Japan
| |
Collapse
|
14
|
Chen J, Hang Y, Gao Q, Huang X. Surgical Diagnosis and Treatment of Primary Retroperitoneal Liposarcoma. Front Surg 2021; 8:672669. [PMID: 34150840 PMCID: PMC8211986 DOI: 10.3389/fsurg.2021.672669] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/10/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Primary retroperitoneal liposarcoma (PRPLS) is the most common soft tissue sarcoma of the retroperitoneum with high recurrence rate and short overall survival (OS). Methods: A retrospective review of 51 patients with PRPLS, treated between September 1, 2009 and November 30, 2020, was conducted to evaluate clinical outcomes of PRPLS resection. Patient demographics, histopathologic subtypes, overall survival (OS), progression-free survival (PFS), disease recurrence rate, and tumor stage were reviewed and analyzed. Univariate analysis was done to identify factors potentially affecting OS and PFS of PRPLS patients. Multivariate Cox proportional hazards analysis was used to evaluate the impact of various clinicopathological factors on OS and PFS of PRPLS patients. Results: Fifty-one PRPLS patients (28 Males, 23 Females; mean age 56.25 years) were evaluated. There was no significant effect of age, gender, contiguous organ resection, degree of differentiation and tumor size on the OS and PFS of the patients. Univariate analysis showed that negative surgical margin and early tumor stage significantly correlated with OS and PFS (all P < 0.001). Multivariate analysis showed that tumor stage [hazard ratio (HR) = 1.177, P = 0.001] was an independent predictors of poor progression-free survival, and surgical margins [HR = 4.0674 P = 0.038] and tumor stage [HR = 1.167 P = 0.001] were identified as independent predictors of poor overall survival. Conclusion: Negative surgical margin is a prognostic factor of OS, and can prolong the postoperative survival time of PRPLS patients. Tumor stage is a prognostic factor for OS and PFS, and can influence the survival of PRPLS patients. Earlier tumor stages of PRPLS are associated with significantly better outcomes.
Collapse
Affiliation(s)
- Jie Chen
- Department of General Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ying Hang
- Department of Emergency, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Qi Gao
- Department of General Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xinyu Huang
- Department of General Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
| |
Collapse
|
15
|
Bartlett EK, Curtin CE, Seier K, Qin LX, Hameed M, Yoon SS, Crago AM, Brennan MF, Singer S. Histologic Subtype Defines the Risk and Kinetics of Recurrence and Death for Primary Extremity/Truncal Liposarcoma. Ann Surg 2021; 273:1189-1196. [PMID: 31283560 PMCID: PMC7561049 DOI: 10.1097/sla.0000000000003453] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We sought to define the prognostic significance of histologic subtype for extremity/truncal liposarcoma (LPS). BACKGROUND LPS, the most common sarcoma, is comprised of 5 histologic subtypes. Despite their distinct behaviors, LPS outcomes are frequently reported as a single entity. METHODS We analyzed data on all patients from a single-institution prospective database treated from July 1982 to September 2017 for primary, nonmetastatic, extremity or truncal LPS of known subtype. Clinicopathologic variables were tested using competing risk analyses for association with disease-specific death (DSD), distant recurrence (DR), and local recurrence (LR). RESULTS Among 1001 patients, median follow-up in survivors was 5.4 years. Tumor size and subtype were independently associated with DSD and DR. Size, subtype, and R1 resection were independently associated with LR. DR was most frequent among pleomorphic and round cell LPS; the former recurred early (43% by 3 years), and the latter over a longer period (23%, 3 years; 37%, 10 years). LR was most common in dedifferentiated LPS, in which it occurred early (24%, 3 years; 33%, 5 years), followed by pleomorphic LPS (18%, 3 years; 25%, 10 years). CONCLUSIONS Histologic subtype is the factor most strongly associated with DSD, DR, and LR in extremity/truncal LPS. Both risk and timing of adverse outcomes vary by subtype. These data may guide selective use of systemic therapy for patients with round cell and pleomorphic LPS, which carry a high risk of DR, and radiotherapy for LPS subtypes at high risk of LR when treated with surgery alone.
Collapse
Affiliation(s)
- Edmund K. Bartlett
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Kenneth Seier
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Li-Xuan Qin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Meera Hameed
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sam S. Yoon
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Aimee M. Crago
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Murray F. Brennan
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Samuel Singer
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| |
Collapse
|
16
|
Nessim C, Raut CP, Callegaro D, Barretta F, Miceli R, Fairweather M, Blay JY, Strauss D, Rutkowski P, Ahuja N, Gonzalez R, Grignani G, Quagliuolo V, Stoeckle E, Lahat G, De Paoli A, Pillarisetty VG, Canter RJ, Mullen JT, Pennacchioli E, van Houdt W, Swallow CJ, Schrage Y, Cardona K, Fiore M, Gronchi A, Bagaria SP. Analysis of Differentiation Changes and Outcomes at Time of First Recurrence of Retroperitoneal Liposarcoma by Transatlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG). Ann Surg Oncol 2021; 28:7854-7863. [PMID: 33907921 DOI: 10.1245/s10434-021-10024-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/03/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Local recurrence following resection of retroperitoneal liposarcoma (RLPS) is common. Well-differentiated (WD) and dedifferentiated (DD) RLPS are distinct entities with differing outcomes. A few reports suggest that WDLPS can recur as DDLPS and that DDLPS can recur as WDLPS. This study evaluates whether this change in differentiation from the primary tumor to the first local recurrence impacts long-term outcomes. METHODS Retrospective review from 22 sarcoma centers identified consecutive patients who underwent resection for a first locally recurrent RLPS from January 2002 to December 2011. Outcomes measured included overall survival, local recurrence, and distant metastasis. RESULTS A total of 421 RPLS patients were identified. Of the 230 patients with primary DDLPS, 34 (15%) presented WDLPS upon recurrence (DD → WD); and of the 191 patients with primary WDLPS, 54 (28%) presented DDLPS upon recurrence (WD → DD). The 6-year overall survival probabilities (95% CI) for DD → DD, DD → WD, WD → WD, and WD → DD were 40% (32-48%), 73% (58-92%), 76% (68-85%), and 56% (43-73%) (p < 0.001), respectively. The 6-year second local recurrence incidence was 66% (59-73%), 63% (48-82%), 66% (57-76%), and 77% (66-90%), respectively. The 6-year distant metastasis incidence was 13% (9-19%), 3% (0.4-22%), 5% (2-11%), and 4% (1-16%), respectively. On multivariable analysis, DD → WD was associated with improved overall survival when compared with DD → DD (p < 0.001). Moreover, WD → DD was associated with a higher risk of LR (p = 0.025) CONCLUSION: A change in RLPS differentiation from primary tumor to first local recurrence appears to impact survival. These findings may be useful in counseling patients on their prognosis and subsequent management.
Collapse
Affiliation(s)
- Carolyn Nessim
- Department of Surgery, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
| | - Chandrajit P Raut
- Department of Surgery, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA, USA
| | - Dario Callegaro
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Francesco Barretta
- Department of Applied Research and Technological Development, Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Rosalba Miceli
- Department of Applied Research and Technological Development, Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Mark Fairweather
- Department of Surgery, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jean-Yves Blay
- Department of Medical Oncology, Center Léon Bérard Cancer Center, Lyon, France
| | - Dirk Strauss
- Department of Surgery, Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Nita Ahuja
- Department of Surgery, Yale School of Medicine, New Haven, CT, USA.,John Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Giovanni Grignani
- Division of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy
| | | | | | - Guy Lahat
- Department of Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Antonino De Paoli
- Department of Radiation Oncology, Centro di Riferimento Oncologico, Aviano, Italy
| | - Venu G Pillarisetty
- Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | | | - John T Mullen
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | | | - Winan van Houdt
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Carol J Swallow
- Department of Surgery, Mount Sinai Hospital and Princess Margaret Cancer Center, Toronto, Canada
| | - Yvonne Schrage
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Surgery, Mount Sinai Hospital and Princess Margaret Cancer Center, Toronto, Canada.,Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Kenneth Cardona
- Department of Surgery, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
| | - Marco Fiore
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | |
Collapse
|
17
|
Ishii K, Yokoyama Y, Nishida Y, Koike H, Yamada S, Kodera Y, Sassa N, Gotoh M, Nagino M. Characteristics of primary and repeated recurrent retroperitoneal liposarcoma: outcomes after aggressive surgeries at a single institution. Jpn J Clin Oncol 2021; 50:1412-1418. [PMID: 32699905 DOI: 10.1093/jjco/hyaa126] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 06/25/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study sought to investigate the characteristics of primary and repeated recurrent retroperitoneal liposarcoma. METHODS Patients treated with primary or recurrent retroperitoneal liposarcoma between 2005 and 2018 were retrospectively reviewed. Survival time analysis of recurrence-free survival and overall survival was conducted using Kaplan-Meier analysis and log-rank test. RESULTS Fifty-two patients with primary retroperitoneal liposarcoma were analysed. Amongst them, 46 patients (88%) had undergone surgery. Histologic grades included well-differentiated (n = 21), dedifferentiated (n = 21), myxoid (n = 3) and pleomorphic (n = 1) subtypes. The patients undergoing R0 resection in the first surgery had significantly higher recurrence-free survival rates compared with the patients undergoing non-R0 resection (3-year recurrence-free survival: 80 versus 38%; 5-year recurrence-free survival: 49 versus 29%, P = 0.033). Although overall survival rates tended to be higher in the patients undergoing R0 resection compared with the non-R0 resection, it did not reach to a statistical significant difference (5-year overall survival: 93 versus 75%; 10-year overall survival: 93 versus 59%, P = 0.124). The recurrence rates were 65, 67, 73 and 100%, and the median recurrence-free survival times were 46, 20, 9 and 3 months after the first, second, third and fourth surgeries, respectively. The 5-year overall survival rates were 82, 69, 40 and 0% after the first, second, third and fourth surgeries, respectively. CONCLUSIONS With repeated recurrence and surgeries, the time to recurrence decreased and the recurrence rate increased. R0 resection in the first surgery was considered the most important for longer recurrence-free survival and radical cure.
Collapse
Affiliation(s)
- Kenta Ishii
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Yukihiro Yokoyama
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | | | - Hiroshi Koike
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Suguru Yamada
- Division of Digestive surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Yasuhiro Kodera
- Division of Digestive surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Naoto Sassa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya
| |
Collapse
|
18
|
Tseng WW, Barretta F, Conti L, Grignani G, Tolomeo F, Albertsmeier M, Angele MK, Rutkowski P, Skoczylas J, De Paoli A, Navarria F, Raut CP, Fairweather M, Farma JM, Nessim C, Goel N, Grignol VP, Ford SJ, Cardona K, Subhawong T, Tattersall HL, Lee RM, Hu JS, Mehren M, Sanfilippo R, Gronchi A. Defining the role of neoadjuvant systemic therapy in high‐risk retroperitoneal sarcoma: A multi‐institutional study from the Transatlantic Australasian Retroperitoneal Sarcoma Working Group. Cancer 2020; 127:729-738. [DOI: 10.1002/cncr.33323] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/28/2020] [Accepted: 10/19/2020] [Indexed: 12/22/2022]
Affiliation(s)
- William W. Tseng
- Division of Breast, Endocrine, and Soft Tissue Surgery Department of Surgery Keck School of Medicine University of Southern California Los Angeles California
| | - Francesco Barretta
- Unit of Clinical Epidemiology and Trial Organization Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Lorenzo Conti
- Sarcoma Service Departments of Surgery and Medical Oncology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Giovanni Grignani
- Division of Medical Oncology Candiolo Cancer InstituteFondazione del Piemonte per l'Oncologia–IRCCS Candiolo Italy
| | - Francesco Tolomeo
- Division of Medical Oncology Candiolo Cancer InstituteFondazione del Piemonte per l'Oncologia–IRCCS Candiolo Italy
| | - Markus Albertsmeier
- Department of General, Visceral, and Transplantation Surgery University Hospital GroßhadernLudwig Maximilian University of Munich Munich Germany
| | - Martin K. Angele
- Department of General, Visceral, and Transplantation Surgery University Hospital GroßhadernLudwig Maximilian University of Munich Munich Germany
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma Maria Sklodowska Curie National Research Institute of Oncology Warsaw Poland
| | - Jacek Skoczylas
- Department of Soft Tissue/Bone Sarcoma and Melanoma Maria Sklodowska Curie National Research Institute of Oncology Warsaw Poland
| | - Antonino De Paoli
- Radiation Oncology Department Centro di Riferimento Oncologico di Aviano (CRO) IRCCS Aviano Italy
| | - Federico Navarria
- Radiation Oncology Department Centro di Riferimento Oncologico di Aviano (CRO) IRCCS Aviano Italy
| | - Chandrajit P. Raut
- Department of Surgery Brigham and Women's Hospital Boston Massachusetts
- Center for Sarcoma and Bone Oncology Dana‐Farber Cancer Institute Harvard Medical School Boston Massachusetts
| | - Mark Fairweather
- Department of Surgery Brigham and Women's Hospital Boston Massachusetts
- Center for Sarcoma and Bone Oncology Dana‐Farber Cancer Institute Harvard Medical School Boston Massachusetts
| | - Jeffrey M. Farma
- Department of Surgical Oncology Fox Chase Cancer Center Philadelphia Pennsylvania
- Department of Hematology/Medical Oncology Fox Chase Cancer Center Philadelphia Pennsylvania
| | - Carolyn Nessim
- Department of Surgery University of Ottawa–Ottawa General Hospital Ottawa Ontario Canada
| | - Neha Goel
- Department of Surgery Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine Miami Florida
- Department of Radiology Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine Miami Florida
| | - Valerie P. Grignol
- Division of Surgical Oncology Department of Surgery James Comprehensive Cancer Center Ohio State University Columbus Ohio
| | - Samuel J. Ford
- Department of Sarcoma Surgery University Hospitals Birmingham Birmingham United Kingdom
| | - Kenneth Cardona
- Division of Surgical Oncology Department of Surgery Winship Cancer InstituteEmory University Atlanta Georgia
| | - Ty Subhawong
- Department of Surgery Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine Miami Florida
- Department of Radiology Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine Miami Florida
| | - Hannah L. Tattersall
- Department of Sarcoma Surgery University Hospitals Birmingham Birmingham United Kingdom
| | - Rachel M. Lee
- Division of Surgical Oncology Department of Surgery Winship Cancer InstituteEmory University Atlanta Georgia
| | - James S. Hu
- Division of Oncology University of Southern California Norris Comprehensive Cancer Center Los Angeles California
| | - Margaret Mehren
- Department of Surgical Oncology Fox Chase Cancer Center Philadelphia Pennsylvania
- Department of Hematology/Medical Oncology Fox Chase Cancer Center Philadelphia Pennsylvania
| | - Roberta Sanfilippo
- Sarcoma Service Departments of Surgery and Medical Oncology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Alessandro Gronchi
- Sarcoma Service Departments of Surgery and Medical Oncology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| |
Collapse
|
19
|
Masaki N, Onozawa M, Inoue T, Kurobe M, Kawai K, Miyazaki J. Clinical features of multiply recurrent retroperitoneal liposarcoma: A single-center experience. Asian J Surg 2020; 44:380-385. [PMID: 33191070 DOI: 10.1016/j.asjsur.2020.10.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/13/2020] [Accepted: 10/22/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND To elucidate the clinicopathological features of multiply recurrent retroperitoneal liposarcoma referred to a tertiary center. METHODS We retrospectively analyzed the clinical data of 40 patients with pathologically proven primary retroperitoneal liposarcoma treated between January 2015 and June 2019. RESULTS The initial pathology was well-differentiated liposarcoma (WDLS) in 23 patients, dedifferentiated liposarcoma (DDLS) in 15 patients, and myxoid liposarcoma in two patients. Before and after referral to our hospital, the patients underwent 142 surgeries (median number of surgeries: 3) for initial and recurrent tumors. Of these, 35 (87.5%) patients underwent surgeries for recurrent tumors. In 11 (47.8%) of the 23 patients with initial WDLS, pathological progression (PP) to DDLS was observed in recurrent tumors at the median interval of 7.8 years. In eight patients (72.7%), the PP occurred at the first recurrence. In contrast, all 15 patients with DDLS recurred as DDLS. Distant metastases developed in eight patients (34.8%) with WDLS and five patients (29.4%) with DDLS/myxoid subtype. All eight WDLS patients who developed metastasis were alive with disease at the median interval of 3.6 years, whereas four of the five patients with primary diagnosis of DDLS/myxoid subtype died at the median interval of 5.6 months from the development of metastasis. The 5-year overall survival of the patients with initial WDLS and those with DDLS/myxoid subtype were 100% and 67.4% (p = 0.0006), respectively. CONCLUSIONS The prognosis of the initial-WDLS patients was favorable despite multiple recurrences. In WDLS patients, if distant metastases develop, it is possible to remain alive with disease for years.
Collapse
Affiliation(s)
- Noriyuki Masaki
- Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Mizuki Onozawa
- Department of Urology, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Takamitsu Inoue
- Department of Urology, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Masahiro Kurobe
- Department of Urology, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Koji Kawai
- Department of Urology, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Jun Miyazaki
- Department of Urology, School of Medicine, International University of Health and Welfare, Narita, Japan.
| |
Collapse
|
20
|
Xue G, Wang Z, Li C, Lv A, Tian X, Wu J, Qiu H, Hao C. A novel nomogram for predicting local recurrence-free survival after surgical resection for retroperitoneal liposarcoma from a Chinese tertiary cancer center. Int J Clin Oncol 2020; 26:145-153. [PMID: 33068222 DOI: 10.1007/s10147-020-01796-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/22/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Local recurrence is the most difficult postoperative challenge and the leading cause of death in patients with retroperitoneal liposarcoma (RLPS). We aimed to establish a postoperative nomogram exclusively focused on RLPS for predicting local recurrence-free survival (LRFS). METHODS A cohort of 124 patients after surgical resection with curative intent in the Peking University Cancer Hospital Sarcoma Center were included in the study. Demographic, clinicopathologic, and treatment variables were analyzed using the Cox regression model. Significant clinically relevant variables in multivariable analysis were incorporated into the RLPS-specific nomogram. The discriminative ability and predictive accuracy of the nomogram were assessed by calculating the concordance index and drawing a calibration plot. RESULTS At a median follow-up of 26.5 (interquartile range 10.9-39.4) months, 71 patients had recurrent disease. The 3-year and 5-year LRFS rates were 35.6% (95% confidence interval, 27.0-46.9%) and 28.2% (95% CI 15.8-38.6%), respectively. Multivariate analysis identified the French Federation of Cancer Centers Sarcoma Group (FNCLCC) grade and completeness of resection as independent predictors of LRFS. Variables included in our nomogram were: presentation status, multifocality, completeness of resection, histologic subtypes, and FNCLCC grade. The concordance index of our nomogram was 0.732 (95% CI 0.667-0.797) and the calibration plot was excellent. CONCLUSIONS Our novel nomogram for patients with resected RLPS could improve recurrence risk stratification to explore molecular analysis associated with recurrence.
Collapse
Affiliation(s)
- Guoqiang Xue
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Zhen Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Chengpeng Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Ang Lv
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Xiuyun Tian
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Jianhui Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Hui Qiu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China
| | - Chunyi Hao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, People's Republic of China.
| |
Collapse
|
21
|
Houdt WJ, Fiore M, Barretta F, Rutkowski P, Blay J, Lahat G, Strauss D, Gonzalez RJ, Ahuja N, Grignani G, Quagliuolo V, Stoeckle E, De Paoli A, Schrage Y, Cardona K, Pennacchioli E, Pillarisetty VG, Nessim C, Swallow CJ, Bagaria SP, Canter R, Mullen JT, Callegaro D, Fairweather M, Miceli R, Raut CP, Gronchi A, Gladdy RA. Patterns of recurrence and survival probability after second recurrence of retroperitoneal sarcoma: A study from TARPSWG. Cancer 2020; 126:4917-4925. [DOI: 10.1002/cncr.33139] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/02/2020] [Accepted: 07/02/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Winan J. Houdt
- Department of Surgical Oncology The Netherlands Cancer Institute Amsterdam The Netherlands
| | - Marco Fiore
- Department of Surgical Oncology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Francesco Barretta
- Medical Statistics, Biometry and Bioinformatics Unit Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma Maria Sklodowska‐Curie Memorial Cancer Center Warsaw Poland
| | - Jean‐Yves Blay
- Department of Medical Oncology Leon Berard Center, Claude Bernard Lyon 1 University Lyon France
| | - Guy Lahat
- Department of General Surgery Tel Aviv Sourasky Medical Center Tel Aviv Israel
| | - Dirk Strauss
- Sarcoma Unit, Department of Surgery Royal Marsden Hospital London United Kingdom
| | | | - Nita Ahuja
- Department of Surgery Yale School of Medicine New Haven Connecticut
| | - Giovanni Grignani
- Sarcoma Unit, Division of Medical Oncology Candiolo Cancer InstituteFPO‐IRCCS Candiolo Italy
| | | | - Eberhard Stoeckle
- Department of Surgery Bergonie InstituteRegional Cancer Centre Bordeaux Cedex France
| | - Antonino De Paoli
- Department of Radiation Oncology Oncology Reference Center (CRO), CRO‐IRCCS Aviano Italy
| | - Yvonne Schrage
- Department of Surgery Leiden University Medical Center Leiden The Netherlands
| | - Kenneth Cardona
- Department of Surgery Winship Cancer InstituteEmory University Atlanta Georgia
| | | | - Venu G. Pillarisetty
- Department of Surgery Seattle Cancer Care AllianceUniversity of Washington School of Medicine Seattle Washington
| | - Carolyn Nessim
- Department of Surgery The Ottawa HospitalUniversity of Ottawa Ottawa Ontario Canada
| | - Carol J. Swallow
- Division of General Surgery Mount Sinai HospitalPrincess Margaret HospitalUniversity of Toronto Toronto Ontario Canada
| | - Sanjay P. Bagaria
- Section of Surgical Oncology Department of Surgery Mayo Clinic Jacksonville Jacksonville Florida
| | - Robert Canter
- Department of Surgery University of California at Davis School of Medicine Davis California
| | - John T. Mullen
- Department of Surgery Massachusetts General HospitalHarvard Medical School Boston Massachusetts
| | - Dario Callegaro
- Department of Surgical Oncology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Mark Fairweather
- Division of Surgical Oncology Department of Surgery Brigham and Women's Hospital Dana‐Farber Cancer Institute Harvard Medical School Boston Massachusetts
| | - Rosalba Miceli
- Medical Statistics, Biometry and Bioinformatics Unit Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Chandrajit P. Raut
- Department of Surgery Massachusetts General HospitalHarvard Medical School Boston Massachusetts
| | - Alessandro Gronchi
- Department of Surgical Oncology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy
| | - Rebecca A. Gladdy
- Division of General Surgery Mount Sinai HospitalPrincess Margaret HospitalUniversity of Toronto Toronto Ontario Canada
| |
Collapse
|
22
|
Abstract
Soft tissue tumors of the abdomen and retroperitoneum encompass a wide range of benign and malignant neoplasms. Retroperitoneal sarcomas, the most common, are composed of rare malignancies with numerous histiotypes. Surgery remains the cornerstone of treatment and the only curative option for retroperitoneal sarcomas. With histiotype-dependent local and distant recurrences, it is imperative these cases are discussed in a multidisciplinary tumor board setting at specialized sarcoma centers. This review discusses the current evidence for the management of abdominal and retroperitoneal soft tissue tumors, with particular focus on retroperitoneal sarcomas and desmoid tumors.
Collapse
|
23
|
|
24
|
Liposarcoma of the left hemithorax and implications of MDM2. JOURNAL OF RADIOTHERAPY IN PRACTICE 2019. [DOI: 10.1017/s1460396919000372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:Use of molecular information to guide clinical management of thoracic liposarcoma following resection.Case presentation:We present a case of a large liposarcoma of the left hemithorax. Initial biopsy consistent with lipoma however following resection pathology showed well-differentiated liposarcoma. Clinical data and molecular information including MDM2 from the tumour were employed in decision making regarding subsequent adjuvant radiation therapy versus close observation.Conclusion:Improved molecular characterisation has increased the precision of histological diagnoses and prediction of outcomes for many cancers. These may continue to help guide and strengthen clinical decision making and recommendations as they pertain to adjuvant therapy versus observation in the case of this patient.
Collapse
|
25
|
Fonseca AL, Roland CL, Cormier JN, Torres KE, Hunt KH, Bishop AJ, Guadagnolo A, Feig BW. Radiation and Its Impact on Local Recurrence in Extremity and Trunk Well-Differentiated Liposarcomas. Am Surg 2019. [DOI: 10.1177/000313481908500126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients with well-differentiated liposarcomas (WDLPS) of the extremity and trunk are treated primarily with surgical resection, with radiation used for a number of anecdotal reasons, including large size and positive margins. In this study, we evaluate the appropriate role for radiation in these tumors. A retrospective chart review of patients with extremity and trunk soft tissue liposarcomas referred to a free-standing cancer center from January 1995 to December 2011 was performed. One hundred eighty-three patients with extremity and trunk soft tissue WDLPS were identified: 61 per cent were female, median age was 60 years (range, 19–84 years) and 2 per cent had a focal area of dedifferentiation, margin status was positive in 57 per cent. Fourteen per cent of patients received radiation. Fifty patients developed recurrent disease; 28 per cent of these received radiation. Median time to recurrence was 18 years (range, 0.7–22 years). Of the 50 patients who recurred, 14 (28%) received radiation. Radiation was associated with decreased second recurrence when administered for recurrent disease (P = 0.03). On multivariable analysis, tumor size ≤ 10 cm (P = 0.014) and anatomically difficult area of resection (P = 0.008) were predictive of increased risk of recurrence. Older age (P = 0.02), dedifferentiated liposarcomas (P < 0.001), and difficult area of resection (P = 0.02) were associated with the administration of radiotherapy. Administration of radiation therapy was not associated with decreased time to recurrence in WDLPS overall; however, it should be considered in patients with recurrent disease.
Collapse
Affiliation(s)
- Annabelle L. Fonseca
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Christina L. Roland
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Janice N. Cormier
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Keila E. Torres
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kelly H. Hunt
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Andrew J. Bishop
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ashleigh Guadagnolo
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Barry W. Feig
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
26
|
Ramu D, Manjunath S, Anuradh G. Recurrent Retroperitoneal Liposarcoma: a Case Report and Literature Review. Indian J Surg Oncol 2018; 9:640-643. [PMID: 30538408 DOI: 10.1007/s13193-018-0774-2] [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: 09/25/2017] [Accepted: 05/08/2018] [Indexed: 11/26/2022] Open
Abstract
This is a case report of a 61-year-old male patient, presented with fifth recurrence of retroperitoneal liposarcoma and operated for six times. Literature review on retroperitoneal liposarcoma biology, recurrence pattern, role of surgery in primary tumor, and recurrent tumor, adjuvant therapy, role of multivisceral resection, and palliative surgery.
Collapse
Affiliation(s)
- D Ramu
- Department of Surgical Oncology, Vikram Hospital, Bangalore, India
| | - Suraj Manjunath
- Department of Surgical Oncology, Vikram Hospital, Bangalore, India
| | - G Anuradh
- Department of Surgical Oncology, Vikram Hospital, Bangalore, India
| |
Collapse
|
27
|
Nathenson MJ, Barysauskas CM, Nathenson RA, Regine WF, Hanna N, Sausville E. Surgical resection for recurrent retroperitoneal leiomyosarcoma and liposarcoma. World J Surg Oncol 2018; 16:203. [PMID: 30309356 PMCID: PMC6182828 DOI: 10.1186/s12957-018-1505-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 09/28/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Retroperitoneal soft tissue sarcomas (STS) include a number of histologies but are rare, with approximately 3000 cases in the USA per year. Retroperitoneal STS have a high incidence of local and distant recurrence. The purpose of this study was to review the University of Maryland Medical Center's (UMMC) treatment experience of retroperitoneal STS, where the patient population served represents a diverse socioeconomic and ethnic catchment. METHODS IRB approval was obtained. We constructed a de-identified database of patients diagnosed with retroperitoneal liposarcomas (LPS) or leiomyosarcomas (LMS) treated at UMMC between 2000 and 2013. A total of 49 patients (Pts) with retroperitoneal STS met our eligibility criteria. Kaplan-Meier plots were used to graphically portray progression-free survival (PFS) and overall survival (OS). The log-rank test was used to compare time-to-event distributions. RESULTS The median OS for all patients (Pts) was 6.3 years, and the 2-year OS rate was 81%. The median PFS for all Pts was 1.8 years, and the 2-year PFS rate was 45%. There was no difference in OS and PFS among LMS and LPS patients; the median OS for LMS was 3.8 years vs. LPS 6.4 years (p = 0.33), and the median PFS for LMS was 1.2 years vs. LPS 2.5 years (p = 0.28). There was a significant difference between histology and race (p = 0.001). LPS were primarily Caucasian 86% vs. 14% black, whereas LMS were primarily black 52% vs. 33% Caucasian. OS was influenced by functional status, gender, American Joint Committee on Cancer (AJCC) stage, grade, histology, tumor size, and extent of resection. PFS was influenced by AJCC stage, grade, and extent of resection. Neither adjuvant chemotherapy (1 Pt) nor neoadjuvant/adjuvant radiation therapy (18 Pts) influenced OS or PFS. There was a non-significant difference that Pts who could undergo resection of local recurrence had improved 2-year OS, with 100% LMS and LPS compared to 2-year OS of 71% (LMS) and 78% (LPS) not undergoing resection of local recurrence. CONCLUSIONS This study suggests a higher incidence of leiomyosarcoma in the African-American population. This study confirms the prognostic importance of grade, tumor size, AJCC stage, histology, and extent of resection in patient outcomes, at a large substantially diverse academic medical center. Future research into the biological features of liposarcoma and leiomyosarcoma Pts imparting these characteristics will be important to define.
Collapse
Affiliation(s)
- Michael J Nathenson
- Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215 USA
| | - Constance M Barysauskas
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215 USA
| | - Robert A Nathenson
- University of Pennsylvania, 3440 Market Street Philadelphia, Philadelphia, PA 19146 USA
| | - William F Regine
- University of Maryland, Greenebaum Cancer Center, South Greene Street Suite 9d10 Baltimore, Baltimore, MD 21201 USA
| | - Nader Hanna
- University of Maryland, Greenebaum Cancer Center, South Greene Street Suite 9d10 Baltimore, Baltimore, MD 21201 USA
| | - Edward Sausville
- University of Maryland, Greenebaum Cancer Center, South Greene Street Suite 9d10 Baltimore, Baltimore, MD 21201 USA
| |
Collapse
|
28
|
Muratori F, Bettini L, Frenos F, Mondanelli N, Greto D, Livi L, Franchi A, Roselli G, Scorianz M, Capanna R, Campanacci D. Myxoid Liposarcoma: Prognostic Factors and Metastatic Pattern in a Series of 148 Patients Treated at a Single Institution. Int J Surg Oncol 2018; 2018:8928706. [PMID: 29977616 PMCID: PMC6011058 DOI: 10.1155/2018/8928706] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 01/31/2018] [Accepted: 03/11/2018] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES The authors reported a retrospective study on myxoid liposarcomas (MLs), evaluating factors that may influence overall survival (OS), local recurrence-free survival (LRFS), metastasis-free survival (MFS), and analyzing the metastatic pattern. METHODS 148 MLs were analyzed. The sites of metastases were investigated. RESULTS Margins (p = 0.002), grading (p = 0,0479), and metastasis (p < 0,0001) were significant risk factors affecting overall survival (OS). Type of presentation (p = 0.0243), grading (p = 0,0055), margin (p = 0.0001), and local recurrence (0.0437) were risk factors on metastasis-free survival (MFS). Authors did not observe statistically significant risk factors for local recurrence-free survival (LRFS) and reported 55% extrapulmonary metastases and 45% pulmonary metastases. CONCLUSION Margins, grading, presentation, local recurrence, and metastasis were prognostic factors. Extrapulmonary metastases were more frequent in myxoid liposarcoma.
Collapse
Affiliation(s)
- Francesco Muratori
- Divisione di Ortopedia Oncologica e Ricostruttiva Ospedale, Azienda Universitaria Ospedaliera Careggi Firenze, Firenze, Italy
| | - Leonardo Bettini
- Divisione di Ortopedia Oncologica e Ricostruttiva Ospedale, Azienda Universitaria Ospedaliera Careggi Firenze, Firenze, Italy
| | - Filippo Frenos
- Divisione di Ortopedia Oncologica e Ricostruttiva Ospedale, Azienda Universitaria Ospedaliera Careggi Firenze, Firenze, Italy
| | - Nicola Mondanelli
- Divisione di Ortopedia Oncologica e Ricostruttiva Ospedale, Azienda Universitaria Ospedaliera Careggi Firenze, Firenze, Italy
| | - Daniela Greto
- Dipartimento di Radioterapia Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Lorenzo Livi
- Dipartimento di Radioterapia Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Alessandro Franchi
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy
| | - Giuliana Roselli
- Divisione di Radiologia Ospedale, Azienda Universitaria Ospedaliera Careggi Firenze, Firenze, Italy
| | - Maurizio Scorianz
- Divisione di Ortopedia Oncologica e Ricostruttiva Ospedale, Azienda Universitaria Ospedaliera Careggi Firenze, Firenze, Italy
| | - Rodolfo Capanna
- Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy
| | - Domenico Campanacci
- Divisione di Ortopedia Oncologica e Ricostruttiva Ospedale, Azienda Universitaria Ospedaliera Careggi Firenze, Firenze, Italy
| |
Collapse
|
29
|
|
30
|
Wang Z, Wu J, Lv A, Li C, Li Z, Zhao M, Hao C. Infiltration characteristics and influencing factors of retroperitoneal liposarcoma: Novel evidence for extended surgery and a tumor grading system. Biosci Trends 2018; 12:185-192. [DOI: 10.5582/bst.2018.01015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Zhen Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of HepatoPancreato-Biliary Surgery, Peking University Cancer Hospital and Institute
| | - Jianhui Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of HepatoPancreato-Biliary Surgery, Peking University Cancer Hospital and Institute
| | - Ang Lv
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of HepatoPancreato-Biliary Surgery, Peking University Cancer Hospital and Institute
| | - Chengpeng Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of HepatoPancreato-Biliary Surgery, Peking University Cancer Hospital and Institute
| | - Zhongwu Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital and Institute
| | - Min Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital and Institute
| | - Chunyi Hao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of HepatoPancreato-Biliary Surgery, Peking University Cancer Hospital and Institute
| |
Collapse
|
31
|
Wang Z, Wu JH, Lv A, Li CP, Tian XY, Hao CY. Anterior Approach to En Bloc Resection in Left-Sided Retroperitoneal Sarcoma with Adjacent Organ Involvement: A Study of 25 Patients in a Single Center. Med Sci Monit 2018; 24:961-969. [PMID: 29449525 PMCID: PMC5824735 DOI: 10.12659/msm.908559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background There is no standard surgical approach for the management of retroperitoneal sarcoma. The aim of this clinical study was to describe the experience of an anterior approach to en bloc resection in left-sided retroperitoneal sarcoma with adjacent organ involvement. Material/Methods This retrospective clinical study included 25 patients who were diagnosed with left-sided retroperitoneal sarcoma and underwent tumor resection at a single center between May 2012 and July 2017. All patients had tumors that were adjacent to the left colon, pancreas, left kidney, left adrenal gland, and psoas major; some of the tumors were adjacent to the diaphragm, stomach, and small intestine. An anterior approach was used to remove the left-sided retroperitoneal tumor with the adhesive organs en bloc, an approach that is described in detail. The value of this surgical approach was evaluated based on the histopathological findings, postoperative complications, and patient follow-up. Results The median number of resected organs, in addition to the retroperitoneal tumor, was 8 (range, 6–10). Complete macroscopic tumor resection was achieved in 23 cases (92%). Twenty-four patients (96%) had tumor infiltration of at least one organ or the surrounding fat. Three patients (12%) experienced Grade III and IV postoperative morbidities. The one-year disease-free survival rate was 91.3% among patients with macroscopically complete resections. The one-year overall survival rate was 83.2%. Conclusions In selected patients, left-sided retroperitoneal sarcoma associated with local organ involvement can be surgically managed using an anterior approach with en bloc resection of adjacent organs.
Collapse
Affiliation(s)
- Zhen Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing, China (mainland)
| | - Jian-Hui Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing, China (mainland)
| | - Ang Lv
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing, China (mainland)
| | - Cheng-Peng Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing, China (mainland)
| | - Xiu-Yun Tian
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing, China (mainland)
| | - Chun-Yi Hao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing, China (mainland)
| |
Collapse
|
32
|
Yamashita K, Kohashi K, Yamada Y, Ishii T, Nishida Y, Urakawa H, Ito I, Takahashi M, Inoue T, Ito M, Ohara Y, Oda Y, Toyokuni S. Osteogenic differentiation in dedifferentiated liposarcoma: a study of 36 cases in comparison to the cases without ossification. Histopathology 2017; 72:729-738. [DOI: 10.1111/his.13421] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/16/2017] [Accepted: 10/24/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Kyoko Yamashita
- Department of Pathology and Biological Responses; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Yuichi Yamada
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Takeaki Ishii
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Yoshihiro Nishida
- Department of Orthopedic Surgery; Nagoya University Graduate School and School of Medicine; Nagoya Japan
| | - Hiroshi Urakawa
- Department of Orthopedic Surgery; Nagoya University Graduate School and School of Medicine; Nagoya Japan
| | - Ichiro Ito
- Department of Pathology; Shizuoka Cancer Center Hospital; Shizuoka Japan
| | - Mitsuru Takahashi
- Division of Orthopaedic Oncology; Shizuoka Cancer Center Hospital; Shizuoka Japan
| | - Takeshi Inoue
- Department of Pathology; Osaka City General Hospital; Osaka Japan
| | - Masafumi Ito
- Department of Pathology; Japanese Red Cross Nagoya First Hospital; Nagoya Japan
| | - Yuuki Ohara
- Department of Pathology and Biological Responses; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | - Shinya Toyokuni
- Department of Pathology and Biological Responses; Nagoya University Graduate School of Medicine; Nagoya Japan
| |
Collapse
|
33
|
Bagaria SP, Gabriel E, Mann GN. Multiply recurrent retroperitoneal liposarcoma. J Surg Oncol 2017; 117:62-68. [DOI: 10.1002/jso.24929] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 10/31/2017] [Indexed: 12/14/2022]
Affiliation(s)
| | | | - Gary N. Mann
- Arnot Health; Department of General and Oncologic Surgery; Elmira NY
| |
Collapse
|
34
|
Prognostic factors and outcome of Liposarcoma patients: a retrospective evaluation over 15 years. BMC Cancer 2017; 17:410. [PMID: 28606068 PMCID: PMC5469180 DOI: 10.1186/s12885-017-3398-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 06/01/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Soft tissue sarcomas are rare entities with over 50 histological subtypes. Liposarcoma (LS) is the most common neoplasm in this group; it is a complex neoplasm that is divided into different histological subtypes. Different therapy options, such as surgical resection, radiation, and chemotherapy, are available. Depending on the subtype, location, status of the resection margins and metastatic status, different therapy options are used. Therefore, the aim of this study was to determine the prognostic factors influencing the survival of patients affected by LS with consideration for the grading, histological subtype, state of the resection margin, size, location, metastases and local recurrence in a retrospective, single-centre analysis over 15 years. METHODS We included 133 patients (male/female = 67/66) in this study. We recorded the histologic subtype, grade, TNM classification, localization, biopsy technique, tumour margins, number of operations, complications, radiation and dose, chemotherapy, survival, recrudescence, metastases and follow-up. Survivorship analysis was performed. RESULTS We detected 56 (43%; 95%-CI 34.6-51.6%) atypical LS cases, 21 (16.2%; 95%-CI 9.8-22.5) dedifferentiated LS cases, 40 (30.8%; 95%-CI 22.8-38.7) myxoid LS cases and 12 (9.2%; 95%-CI 4.3-14.2) pleomorphic LS cases. G1 was the most common grade, which was followed by G3. Negative margins (R0) were detected in 67 cases (53.6%; 95%-CI 44.9-62.3) after surgical resection. Local recurrence was detected in 23.6% of cases. The presence of metastases and dedifferentiated LS subtype as well as negative margins, grade and tumour size are significant prognostic factors of the survival rates (p < 0.015). CONCLUSION Grading, LS subtype, negative margins after surgery, metastases and tumour size are independently associated with disease-specific survival, and patients with local recurrence had lower survival rates. We hope our investigation may facilitate a further prospective study and clinical decision-making in LS.
Collapse
|
35
|
Mandelia A, Kishore J, Soni N, Rao RN, Lal R. Fungating myxoid liposarcoma of left gluteal region in an infant. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2017. [DOI: 10.1016/j.epsc.2017.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
36
|
MacNeill AJ, Miceli R, Strauss DC, Bonvalot S, Hohenberger P, Van Coevorden F, Rutkowski P, Callegaro D, Hayes AJ, Honoré C, Fairweather M, Cannell A, Jakob J, Haas RL, Szacht M, Fiore M, Casali PG, Pollock RE, Raut CP, Gronchi A, Swallow CJ. Post-relapse outcomes after primary extended resection of retroperitoneal sarcoma: A report from the Trans-Atlantic RPS Working Group. Cancer 2017; 123:1971-1978. [PMID: 28152173 DOI: 10.1002/cncr.30572] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/16/2016] [Accepted: 12/28/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Despite a radical surgical approach to primary retroperitoneal sarcoma (RPS), many patients experience locoregional and/or distant recurrence. The objective of this study was to analyze post-relapse outcomes for patients with RPS who had initially undergone surgical resection of their primary tumor at a specialist center. METHODS All consecutive patients who underwent macroscopically complete resection for primary RPS at 8 high volume centers from January 2002 to December 2011 were identified, and those who developed local recurrence (LR) only, distant metastasis (DM) only, or synchronous local recurrence and distant metastasis (LR+DM) during the follow-up period were included. Overall survival (OS) was calculated for all groups, as was the crude cumulative incidence of a second recurrence after the first LR. Multivariate analyses for OS were performed. RESULTS In an initial series of 1007 patients with primary RPS, 408 patients developed recurrent disease during the follow-up period. The median follow-up from the time of recurrence was 41 months. The median OS was 33 months after LR (n = 219), 25 months after DM (n = 146), and 12 months after LR+DM (n = 43), and the 5-year OS rates were 29%, 20%, and 14%, respectively. Predictors of OS after LR were the time interval to LR and resection of LR, while histologic grade approached significance. For DM, significant predictors of OS were the time interval to DM and histologic subtype. The subgroup of patients who underwent resection of recurrent disease had a longer median OS than patients who did not undergo resection. CONCLUSIONS Relapse of RPS portends high disease-specific mortality. Patients with locally recurrent or metastatic disease should be considered for resection. Cancer 2017;123:1971-1978. © 2017 American Cancer Society.
Collapse
Affiliation(s)
- Andrea J MacNeill
- Department of Surgical Oncology, Mount Sinai Hospital and Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.,Department of Surgery, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Rosalba Miceli
- Department of Biostatistics, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Dirk C Strauss
- Department of Surgery, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Peter Hohenberger
- University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Frits Van Coevorden
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Dario Callegaro
- Department of Surgery, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Andrew J Hayes
- Department of Surgery, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Charles Honoré
- Department of Surgery, Gustave Roussy Institute, Villejuif, France
| | - Mark Fairweather
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital and Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Amanda Cannell
- Ontario Institute for Cancer Research, MaRS Centre, Toronto, Ontario, Canada
| | - Jens Jakob
- University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Rick L Haas
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Milena Szacht
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland
| | - Marco Fiore
- Department of Surgery, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Paolo G Casali
- Department of Cancer Medicine, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Raphael E Pollock
- Division of Surgical Oncology, Department of Surgery, Ohio State University Medical Center, Columbus, Ohio
| | - Chandrajit P Raut
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital and Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Alessandro Gronchi
- Department of Surgery, IRCCS Foundation National Cancer Institute, Milan, Italy
| | - Carol J Swallow
- Department of Surgical Oncology, Mount Sinai Hospital and Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
37
|
Radiological diagnosis of perinephric pathology: pictorial essay 2015. Insights Imaging 2017; 8:155-169. [PMID: 28050791 PMCID: PMC5265200 DOI: 10.1007/s13244-016-0536-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/14/2016] [Accepted: 11/23/2016] [Indexed: 02/07/2023] Open
Abstract
The perinephric space, shaped as an inverted cone, sits between the anterior and posterior renal fasciae. It can play host to a variety of clinical conditions encountered daily in the reporting schedule for a radiologist. Lesions may be classified and diagnosed based on their imaging characteristics, location and distribution. A broad range of differential diagnoses can be attributed to pathology sitting within this space, often without clinical signs or symptoms. An understanding of commonly encountered conditions affecting the perinephric space, along with characteristic imaging findings, can illustrate and often narrow the likely diagnosis. The aim of this essay is to describe commonly encountered neoplastic and non-neoplastic entities involving the perinephric space and to describe their key imaging characteristics. TEACHING POINT • Despite often a bulky disease, perinephric lymphoma does not produce obstruction or stenosis. • In primarily fatty masses, defects within the renal capsule likely represent angiomyolipoma. • Consider paraganglioma if biopsy is planned; biopsy may lead to catecholamine crisis.
Collapse
|
38
|
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.
Collapse
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
| |
Collapse
|
39
|
Klooster B, Rajeev R, Chrabaszcz S, Charlson J, Miura J, Bedi M, Gamblin TC, Johnston F, Turaga KK. Is long-term survival possible after margin-positive resection of retroperitoneal sarcoma (RPS)? J Surg Oncol 2016; 113:823-7. [PMID: 27060344 DOI: 10.1002/jso.24232] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 03/11/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES For various reasons, some patients undergo a gross margin positive resection (R2) leading to a dilemma in care. We hypothesized that there is a subset of patients who have long-term survival (LTS, ≥5 years) after R2 resection for retroperitoneal sarcoma (RPS). METHODS National Cancer Database data from 1998 to 2011 were reviewed to identify patients with RPS who had R2 resections. Logistic and Cox regression models were used to compare LTS with short-term survival. RESULTS Of 12,028 patients, R2 resection rate was 3.28% (4.9% in 1998; 2.5% in 2011). Median survival for RPS with R2 resection was 21 months versus 69 months for those with R0/R1 resections (P < 0.001). Of 272 patients with available survival, 24% (n = 64) survived ≥5 years with 64% alive at follow-up. LTS was most often seen in younger patients (<65 years) with well-differentiated liposarcoma. Chemotherapy appeared to improve survival in the first 3 postoperative years, but paradoxical effects were seen in LTS (Hazards Ratio [HR] 0.69, 95%CI: 0.50-0.95, P = 0.024) in first 3 years versus (HR 2.15, 95%CI: 1.21-3.81, P = 0.009). CONCLUSION Long-term survival is possible for a subset of patients after an R2 resection for RPS, especially with favorable histology characteristics. Benefits of chemotherapy in margin positive settings need to be investigated. J. Surg. Oncol. 2016;113:823-827. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Brittany Klooster
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rahul Rajeev
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Sarah Chrabaszcz
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - John Charlson
- Section of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - John Miura
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Meena Bedi
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Thomas Clark Gamblin
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Fabian Johnston
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Kiran K Turaga
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| |
Collapse
|
40
|
Ishii T, Kohashi K, Iura K, Maekawa A, Bekki H, Yamada Y, Yamamoto H, Nabeshima K, Kawashima H, Iwamoto Y, Oda Y. Activation of the Akt-mTOR and MAPK pathways in dedifferentiated liposarcomas. Tumour Biol 2015; 37:4767-76. [PMID: 26518767 DOI: 10.1007/s13277-015-4232-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 10/12/2015] [Indexed: 11/27/2022] Open
Abstract
The Akt/mTOR and MAPK pathways play important roles in modulating cellular function in response to extracellular signals, and they are known to be activated in certain kinds of sarcomas. Few investigations have examined these pathways in dedifferentiated liposarcoma (DDLS), in relation to clinicopathological features. Clinicopathological and immunohistochemical analyses were conducted using 99 DDLS specimens. An in vitro study was also conducted to examine the antitumor effects of an mTOR inhibitor and a MEK inhibitor on two DDLS cell lines. The clinicopathological analyses revealed that the AJCC staging was a significant prognostic factor for overall survival and that the tumor size, depth, and location were significant prognostic factors for event-free survival. Phosphorylated Akt (pAkt), pmTOR, pS6RP, p4E-BP1, pMEK, and pERK expressions were positive in 57.4, 52.4, 71.4, 57.1, 84.1, and 50.8 % of the dedifferentiated component of the 63 primary DDLSs. Positive staining for pmTOR was significantly more frequent in the dedifferentiated component than the well-differentiated component. A univariate prognostic analysis revealed that pmTOR expression was associated with poor prognosis in the tumors in the retroperitoneum/ventral body cavity. The mTOR and MEK inhibitors dose-dependently inhibited the cell proliferation of both DDLS cell lines and decreased the expression of downstream pS6RP and pERK, respectively. The combined use of the two inhibitors enhanced antiproliferative activity. In conclusion, the Akt/mTOR and MAPK pathways were activated in DDLS specimens, and the inhibition of these pathways decreased cell proliferation in DDLS cell lines. Our findings suggest that these pathways could be a therapeutic target for patients with DDLS.
Collapse
Affiliation(s)
- Takeaki Ishii
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kunio Iura
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Akira Maekawa
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hirofumi Bekki
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yuichi Yamada
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Fukuoka University School of Medicine and Hospital, Fukuoka, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yukihide Iwamoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan.
| |
Collapse
|
41
|
Zhao X, Li P, Huang X, Chen L, Liu N, She Y. Prognostic factors predicting the postoperative survival period following treatment for primary retroperitoneal liposarcoma. Chin Med J (Engl) 2015; 128:85-90. [PMID: 25563319 PMCID: PMC4837826 DOI: 10.4103/0366-6999.147822] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Liposarcomas, which represent 20% of all adult sarcomas, are the most common histological type of malignant soft tissue tumors. The aim of this study was to define the prognostic factors that predict the postoperative survival period for patients with primary retroperitoneal liposarcoma. Methods: The clinical data and prognoses of 71 patients with primary retroperitoneal liposarcoma who were treated in the General Hospital of the People's Liberation Army of China between January 1, 2000 and December 31, 2007 were retrospectively reviewed and analyzed. Results: The primary tumor from each patient was resected; 54.9% (39/71) were deemed R0 resections, 31.0% (22/71) were R1 resections and 14.1% (10/71) were deemed R2 resections (palliative operations). The median follow up was 68 months (range: 1-160 months). Of the patients who received an R1 or R2 resection of their primary tumor, 96.7% (59/61) had tumor recurrence. The 1-year, 3-year, and 5-year recurrence-free rates were 77.0%, 29.8% and 19.7%, respectively. As of April 2013, 53 of the 71 patients had died from tumor recurrence. The overall 1-year, 3-year, 5-year, and 10-year survival rates were 88.7%, 76.1%, 61.7%, and 30.4%, respectively. The factors that were significantly associated with prognosis in the univariate analysis were age (as a categorical variable) (P = 0.006), modus operandi (P = 0.000), histologic subtype (P = 0.000), tumor grade (P = 0.000), ascites (P = 0.000), postoperative metastasis (P = 0.000) and adjuvant therapy (P = 0.030). However, in the multivariate analysis, the modus operandi (P = 0.000), tumor grade (P = 0.006), ascites (P = 0.027), postoperative metastasis (P = 0.023) and age (as a categorical variable) (P = 0.002) were the only significant predictors of survival. Conclusions: Complete resection remains the most effective method for treating liposarcoma. High grade, old age (≥60 years old), postoperative metastasis, and ascites predict poor prognoses.
Collapse
Affiliation(s)
| | - Peiyu Li
- Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China
| | | | | | | | | |
Collapse
|
42
|
Comparison of Perioperative Radiation Therapy and Surgery Versus Surgery Alone in 204 Patients With Primary Retroperitoneal Sarcoma: A Retrospective 2-Institution Study. Ann Surg 2015; 262:156-62. [PMID: 26061213 DOI: 10.1097/sla.0000000000001063] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare outcomes of patients with retroperitoneal or pelvic sarcoma treated with perioperative radiation therapy (RT) versus those treated without perioperative RT. BACKGROUND RT for retroperitoneal or pelvic sarcoma is controversial, and few studies have compared outcomes with and without RT. METHODS Prospectively maintained databases were reviewed to retrospectively compare patients with primary retroperitoneal or pelvic sarcoma treated during 2003-2011. Multivariate Cox regression models were used to assess associations with the primary endpoints: local recurrence-free survival (LRFS) and disease-specific survival. RESULTS At 1 institution, 172 patients were treated with surgery alone, whereas at another institution 32 patients were treated with surgery and perioperative proton beam RT or intensity-modulated RT with or without intraoperative RT. The groups were similar in age, tumor size, grade, and margin status (all P > 0.08). The RT group had a higher percentage of pelvic tumors (P = 0.03) and a different distribution of histologies (P = 0.04). Perioperative morbidity was higher in the RT group (44% vs 16% of patients; P = 0.004). After a median follow-up of 39 months, 5-year LRFS was 91% (95% confidence interval, 79%-100%) in the RT group and 65% (57%-74%) in the surgery-only group (P = 0.02). On multivariate analysis, RT was associated with better LRFS (hazard ratio, 0.26; P = 0.03). Five-year disease-specific survival was 93% (95% confidence interval, 82%-100%) in the RT group and 85% (78%-92%) in the surgery-only group (P = 0.3). CONCLUSIONS The addition of advanced-modality RT to surgery for primary retroperitoneal or pelvic sarcoma was associated with improved LRFS, although this did not translate into significantly better disease-specific survival. This treatment strategy warrants further investigation in a randomized trial.
Collapse
|
43
|
Hwang JA, Yang HM, Hong DP, Joo SY, Choi YL, Park JH, Lazar AJ, Pollock RE, Lev D, Kim SJ. Gankyrin is a predictive and oncogenic factor in well-differentiated and dedifferentiated liposarcoma. Oncotarget 2015; 5:9065-78. [PMID: 25238053 PMCID: PMC4253419 DOI: 10.18632/oncotarget.2375] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Liposarcoma is one of the most common histologic types of soft tissue sarcoma and is frequently an aggressive cancer with poor outcome. Hence, alternative approaches other than surgical excision are necessary to improve treatment of well-differentiated/dedifferentiated liposarcoma (WDLPS/DDLPS). For this reason, we performed a two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionization-time of flight mass spectrometry/mass spectrometry (MALDI-TOF/MS) analysis to identify new factors for WDLPS and DDLPS. Among the selected candidate proteins, gankyrin, known to be an oncoprotein, showed a significantly high level of expression pattern and inversely low expression of p53/p21 in WDLPS and DDLPS tissues, suggesting possible utility as a new predictive factor. Moreover, inhibition of gankyrin not only led to reduction of in vitro cell growth ability including cell proliferation, colony-formation, and migration, but also in vivo DDLPS cell tumorigenesis, perhaps via downregulation of the p53 tumor suppressor gene and its p21 target and also reduction of AKT/mTOR signal activation. This study identifies gankyrin, for the first time, as new potential predictive and oncogenic factor of WDLPS and DDLPS, suggesting the potential for service as a future LPS therapeutic approach.
Collapse
Affiliation(s)
- Ju-Ae Hwang
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea. Department of Biology, Changwon National University, Changwon, Kyungnam, Republic of Korea
| | - Heung-Mo Yang
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Doo-Pyo Hong
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Sung-Yeon Joo
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea. Samsung Advanced Institute for Health Sciences and Technology, Graduate School, Department of Health Sciences and Technology, Sungkyunkwan University
| | - Yoon-La Choi
- Department of Pathology, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joo-Hung Park
- Department of Biology, Changwon National University, Changwon, Kyungnam, Republic of Korea
| | - Alexander J Lazar
- Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Raphael E Pollock
- Division of Surgical Oncology, James Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA
| | - Dina Lev
- Department of Cancer Biology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sung Joo Kim
- Transplantation Research Center, Samsung Biomedical Research Institute, Seoul, Republic of Korea. Department of Surgery, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Sarcoma Research Center, Samsung Medical Center, Seoul, Republic of Korea
| |
Collapse
|
44
|
Ben Nsir A, Boubaker A, Kassar AZ, Abderrahmen K, Kchir N, Jemel H. Multiple spinal metastases from a well-differentiated liposarcoma of the iliac wing: a case report. Spinal Cord Ser Cases 2015; 1:15007. [PMID: 28053711 DOI: 10.1038/scsandc.2015.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 01/23/2015] [Accepted: 01/27/2015] [Indexed: 01/22/2023] Open
Abstract
STUDY DESIGN A case report. OBJECTIVES To report an unusual case of multiple spinal metastases from an undiagnosed well-differentiated liposarcoma (WDLPS) of the iliac wing and to stress the need of a meticulous clinical examination and further screening of patients with chronic and asymptomatic bony lesions. SETTING University of medicine of Monastir, Department of neurological surgery, Fattouma Bourguiba University Hospital, Monastir, Tunisia and University of Medicine of Tunis EL Manar, Department of neurological surgery, Tunisian National Institute of Neurology, Tunis, Tunisia. METHODS A 39-year-old man presented with signs of spinal cord compression for the past 2 weeks. His medical history was consistent for an asymptomatic right iliac wing mass that appeared 3 years ago and for which he has not consulted. Magnetic resonance imaging revealed multiple bony lesions of the thoraco-lumbar spine associated with a 6-cm right paravertebral mass at the T4 level extending posteriorly through the intervertebral foramina to the spinal canal causing major spinal cord compression. An emergent T2-T6 laminectomy allowed for a complete resection of the epidural mass. Pathological examination confirmed the diagnosis of well-differentiated liposarcoma. Adjunctive radiation therapy was administered. RESULTS The patient's neurological status improved remarkably under an intensive care and rehabilitation program. He was ambulatory without assistance in the second postoperative week. CONCLUSION The case reported in this paper represents a genuine example of the possible metastatic potential of WDLPSs of the bone and underscores the importance of examining patients thoroughly, especially when they have chronic and asymptomatic lesions.
Collapse
Affiliation(s)
- A Ben Nsir
- Neurological Surgery Department, Fattouma Bourguiba University Hospital , Monastir, Tunisia
| | - A Boubaker
- Neurological Surgery Department, Tunisian National Institute of Neurology, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis, Tunisia
| | - A Z Kassar
- Pathology Department, La Rabta university hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis, Tunisia
| | - K Abderrahmen
- Neurological Surgery Department, Tunisian National Institute of Neurology, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis, Tunisia
| | - N Kchir
- Pathology Department, La Rabta university hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis, Tunisia
| | - H Jemel
- Neurological Surgery Department, Tunisian National Institute of Neurology, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis, Tunisia
| |
Collapse
|
45
|
Eisinger-Mathason TSK, Mucaj V, Biju KM, Nakazawa MS, Gohil M, Cash TP, Yoon SS, Skuli N, Park KM, Gerecht S, Simon MC. Deregulation of the Hippo pathway in soft-tissue sarcoma promotes FOXM1 expression and tumorigenesis. Proc Natl Acad Sci U S A 2015; 112:E3402-11. [PMID: 26080399 PMCID: PMC4491775 DOI: 10.1073/pnas.1420005112] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Genetic aberrations responsible for soft-tissue sarcoma formation in adults are largely unknown, with targeted therapies sorely needed for this complex and heterogeneous family of diseases. Here we report that that the Hippo pathway is deregulated in many soft-tissue sarcomas, resulting in elevated expression of the effector molecule Yes-Associated Protein (YAP). Based on data gathered from human sarcoma patients, a novel autochthonous mouse model, and mechanistic analyses, we determined that YAP-dependent expression of the transcription factor forkhead box M1 (FOXM1) is necessary for cell proliferation/tumorigenesis in a subset of soft-tissue sarcomas. Notably, FOXM1 directly interacts with the YAP transcriptional complex via TEAD1, resulting in coregulation of numerous critical pro-proliferation targets that enhance sarcoma progression. Finally, pharmacologic inhibition of FOXM1 decreases tumor size in vivo, making FOXM1 an attractive therapeutic target for the treatment of some sarcoma subtypes.
Collapse
Affiliation(s)
- T S Karin Eisinger-Mathason
- Abramson Family Cancer Research Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104
| | - Vera Mucaj
- Abramson Family Cancer Research Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104
| | - Kevin M Biju
- Abramson Family Cancer Research Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104
| | - Michael S Nakazawa
- Abramson Family Cancer Research Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104
| | - Mercy Gohil
- Abramson Family Cancer Research Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104
| | - Timothy P Cash
- Abramson Family Cancer Research Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104
| | - Sam S Yoon
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065
| | - Nicolas Skuli
- INSERM U1037, Institut Claudius Regaud, 31052 Toulouse, France
| | - Kyung Min Park
- Department of Chemical and Biomolecular Engineering, Johns Hopkins Physical Sciences-Oncology Center, and the Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD 21218
| | - Sharon Gerecht
- Department of Chemical and Biomolecular Engineering, Johns Hopkins Physical Sciences-Oncology Center, and the Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD 21218; Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD 21218
| | - M Celeste Simon
- Abramson Family Cancer Research Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104; Howard Hughes Medical Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104
| |
Collapse
|
46
|
Liposarcoma with lymph node spread: a case presentation and a systematic review of the literature. Eur Surg 2015. [DOI: 10.1007/s10353-015-0314-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
47
|
Gemici K, Buldu İ, Acar T, Alptekin H, Kaynar M, Tekinarslan E, Karatağ T, Efe D, Çolak H, Küçükkartallar T, İstanbulluoğlu MO. Management of patients with retroperitoneal tumors and a review of the literature. World J Surg Oncol 2015; 13:143. [PMID: 25881253 PMCID: PMC4404658 DOI: 10.1186/s12957-015-0548-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 03/16/2015] [Indexed: 11/21/2022] Open
Abstract
Background Retroperitoneal tumors (RTs) develop insidiously and are generally seen as large masses, and 50% of RTs are larger than 20 cm at the time of diagnosis. In this article, we share our experience of 5 years of surgical management of RTs. Methods We evaluated 28 RT cases operated on in three education hospitals in Turkey from January 2008 onwards, with regard to patients’ demographic characteristics, complaints, weight loss figures, the location and size of the tumor, blood transfusion, intra-operational time, metastases (in malignant cases), additional organ resection, histological grade, local recurrences, average life expectancy, and post-operative treatment methods. Results The mean age of the patients was 49 years (range, 18 to 78 years). Twenty (71.43%) were female, and 8 (28.57%) were male. The primary complaint was abdominal pain in 18 patients (64.28%). CT scans were performed in 17 (61%) patients, 10 (35.4%) underwent abdominal MR imaging, and 1 (3.6%) underwent both abdominal CT and abdominal MR imaging. A mass was palpated in the pelvis (suprapubic region) in seven (25%) of the patients during physical examination. The largest tumors were detected in the left lumbar area. The mean tumor size was 12.78 cm (range, 2 to 30 cm). The mean intra-operational time was 192 min (range, 70 to 380 min). The mean hospitalization period was 11 days (range, 8 to 23 days). Seven (25%) patients were reported to have benign tumors, while 21 (75%) were reported to have malignant tumors. The most frequently seen malignant pathology was liposarcoma (eight cases; 38.09%) followed by leiomyosarcoma (five cases; 23.8%) and malignant fibrous histiocytoma (four cases; 19.04%). The earliest local recurrence was detected in the 12th month and the latest in the 28th month. A total of 11 (52.3%) of the total of 21 malignant cases experienced local recurrence within 3 years. The 3-year average life expectancy was 85.7% in the 18 malignant cases. Conclusions Due to the low response rate of all but two types of RT to chemotherapy, the best remaining treatment option is surgery with wide resection margins, whereby all macroscopic traces of tumor are removed.
Collapse
Affiliation(s)
- Kazım Gemici
- Faculty of Medicine, Department of General Surgery, Mevlana University, Konya, Turkey.
| | - İbrahim Buldu
- Faculty of Medicine, Department of Urology, Mevlana University, Konya, Turkey.
| | - Türker Acar
- Faculty of Medicine, Department of Radiology, Mevlana University, Konya, Turkey.
| | - Hüsnü Alptekin
- Faculty of Medicine, Department of Gynaecology, Mevlana University, Konya, Turkey.
| | - Mehmet Kaynar
- Konya Education and Research Hospital, Konya, Turkey.
| | | | - Tuna Karatağ
- Faculty of Medicine, Department of Urology, Mevlana University, Konya, Turkey.
| | - Duran Efe
- Faculty of Medicine, Department of Radiology, Mevlana University, Konya, Turkey.
| | - Haldun Çolak
- Faculty of Medicine, Department of General Surgery, Necmettin Erbakan University, Konya, Turkey.
| | - Tevfik Küçükkartallar
- Faculty of Medicine, Department of General Surgery, Necmettin Erbakan University, Konya, Turkey.
| | | |
Collapse
|
48
|
|
49
|
Yang JY, Kong SH, Ahn HS, Lee HJ, Jeong SY, Ha J, Yang HK, Park KJ, Lee KU, Choe KJ. Prognostic factors for reoperation of recurrent retroperitoneal sarcoma: The role of clinicopathological factors other than histologic grade. J Surg Oncol 2014; 111:165-72. [DOI: 10.1002/jso.23783] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 08/09/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Jun-Young Yang
- Department of Surgery; Seoul National University College of Medicine; Seoul Korea
| | - Seong-Ho Kong
- Department of Surgery; Seoul National University College of Medicine; Seoul Korea
| | - Hye Seong Ahn
- Department of Surgery; Seoul National University College of Medicine; Seoul Korea
| | - Hyuk-Joon Lee
- Department of Surgery; Seoul National University College of Medicine; Seoul Korea
- Cancer Research Institute; Seoul National University College of Medicine; Seoul Korea
| | - Seung-Yong Jeong
- Department of Surgery; Seoul National University College of Medicine; Seoul Korea
| | - Jongwon Ha
- Department of Surgery; Seoul National University College of Medicine; Seoul Korea
| | - Han-Kwang Yang
- Department of Surgery; Seoul National University College of Medicine; Seoul Korea
- Cancer Research Institute; Seoul National University College of Medicine; Seoul Korea
| | - Kyu Joo Park
- Department of Surgery; Seoul National University College of Medicine; Seoul Korea
| | - Kuhn Uk Lee
- Department of Surgery; Seoul National University College of Medicine; Seoul Korea
| | - Kuk Jin Choe
- Department of Surgery; Seoul National University College of Medicine; Seoul Korea
| |
Collapse
|
50
|
Lu J, Qin Q, Zhan LL, Yang X, Xu Q, Yu J, Dou LN, Zhang H, Yang Y, Chen XC, Yang YH, Cheng HY, Sun XC. Computed Tomography Manifestations of Histologic Subtypes of Retroperitoneal Liposarcoma. Asian Pac J Cancer Prev 2014; 15:6041-6. [DOI: 10.7314/apjcp.2014.15.15.6041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|