J Korean Bone Joint Tumor Soc.  2010 Jun;16(1):14-20. 10.5292/jkbjts.2010.16.1.14.

Prognostic Factors in Liposarcomas: A Retrospective Study of 52 Patients

• Chung YG
• Kang YK
• Bahk WJ
• Rhee SK
• Lee AH
• Park JM
• Kim MW

• KMID: 2006337
• DOI: http://doi.org/10.5292/jkbjts.2010.16.1.14

Abstract

PURPOSE
To investigate prognostic factors influencing on local recurrence, distant metastasis and event-free survival of liposarcomas.
MATERIALS AND METHODS
Fifty-two patients managed for liposarcomas since 1993 were analyzed respectively in the view of prognostic influence of patient age, tumor size, location, histologic type, histologic grade, resection type, surgical margin, chemotherapy and radiation therapy on local recurrence, distant metastasis and event-free survival. The mean follow up period was 39 months. The univariate and multivariate regression analysis were performed for statistical evaluation.
RESULTS
The local recurrences occurred in 11 patients (21.2%) and distant metastasis in 4 patients (8%), Event-free survival rate at 4 year follow up was 67%. In univariate analysis, histologic grade, surgical margin, chemotherapy and radiation therapy were significant prognostic factors on local recurrence (p<0.05). However, histologic grade lost its significance in muitivariate analysis. Trunk location revealed higher rate of distant metastasis than extremity location. In univariate analysis on event-free survival. histologic grade and chemotherapy were significant factors (p<0.05). No factor remained significant in multivariate analysis.
CONCLUSION
Considering selection bias, positive surgical margin was negative prognostic factor on local recurrence. Liposarcomas arisen in trunk revealed higher rate of distant metastasis. There was no independent prognostic factor on event-free survival of patients with liposarcomas.

Keyword

liposarcomas; local recurrence; distant metastasis; event-free survival; prognostic factors

MeSH Terms

Disease-Free Survival
Extremities
Follow-Up Studies
Humans
Liposarcoma
Multivariate Analysis
Neoplasm Metastasis
Recurrence
Retrospective Studies
Selection Bias

Figure

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  Figure 1. The cummulative event free survival rates were 67% at 4 year and 55% at 10 year followup.

Reference

1. Koea JB, Leung D, Lewis JJ, et al. Histopathologic type: an independent prognostic factor In primary soft tissue sarcoma of the extremity? Ann Surg Oncol. 2003; 10:342–440.

2. Lewis JJ, Leung D, Casper ES, et al. Multifactorial analysis of longterm followup (more than 5 years) of primary extremity sarcoma. Arch Surg. 1999; 134:190–4.

3. Dalal KM, Kattan MW, Antonescu CR, Brennan MF, Singer S. Subtype specific prognostic nanogram for patients with primary liposarcoma of the retroperitoneum, extremity, or trunk. Ann Surg. 2006; 244:381–91.

4. Eilber FC, Eilber FR, Eckardt J, et al. The impact of chemo-theraphy on the survival of patients with high-grade primary extremity liposarcoma. Ann Surg. 2004; 240:686–95.

5. Fiore M, Grosso F, Lo Vullo S, et al. Myxoid/round cell and pleomor phic liposarcomas. Cancer. 2007; 109:2522–31.

6. Heuvel SE, Hoekstra HJ, van Ginkel RJ, Bastiaannet E, Suur-meijer A. Clinicopathologic prognostic factors in myxoid liposarcoma: a retrospective study of 49 patients with longterm followup. Ann Surg Oncol. 2007; 14:222–9.

7. Zagars GK, Goswitz MS, Pollack A. Liposarcoma: outcome and prognostic factors following conservation surgery and radiation therapy. Int J Radiation Oncology Biol Phys. 1996; 36:311–9.

8. Fleming ID, Cooper JS, Henson DE, et al. AJCC Cancer Staging Mannual. 5th ed.Philadelphia: Lippincott-Raven;1997. p. 140–6.

9. Evans HL. Liposarcoma. a study of 55 cases with a reassessment of its classification. Am J Surg Pathol. 1979; 3:507–23.

10. Liu CU, Yen CC, Chen WM, et al. Soft tissue sarcoma of extremities: the prognostic significance of adequate surgical margin in primary operation and reoperation after recurrence. Ann Surg Oncol; [published online 2010 March 9].

11. Singer S, Antonescu CR, Riedel E, Brennan MF. Histologic subtype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma. Ann Surg. 2003; 238:358–71.

12. Stojadinovic A, Leung D, Hoos A, Jaques D, Lewis J, Brennan M. Analysis of the prognostic significance of microscopic margins in 2084 localized primary adult soft tissue sarcomas. Ann of Surg. 2002; 235:424–34.

13. Trojani M, Contesso G, Coindre JM, et al. Soft tissue sarcoma of adults: study of pathological prognostic variables and definition of a histopathologic grading system. Int J Cancer. 1984; 33:37–42.

14. Antonescu CR, Tschernyavsky SJ, Decuseara R, et al. Prognostic impact of P53 status. TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma: a molecular and clinicopathologic study of 82 cases. Clin Cancer Res. 2001; 7:3977–87.

15. Gebhard S, Coindre JM, Michels JJ, et al. Pleomorphic liposarcoma: clinicopathologic, immunohistochemical, and followup analysis of 63 cases: a study from the French Federation of cancer centers sarcoma group. Am J Surg Pathol. 2002; 26:601–16.

16. Henricks WH, Chu YC, Goldblum Jr, et al. Dedifferentiated liposarcoma: a clinocopathological analysis of 155 cases with a proposal for an expanded definition of dedifferentiation. Am J Surg Pathol. 1997; 21:271–81.

17. Linehan DC, Leung J, Leung D, et al. Influence of biologic factors and anatomic site in completely resected liposarcoma. J Clin Oncol. 2000; 18:1637–43.

18. McComick D, Mentzel T, Beham A, et al. Dedifferentiated liposarcoma: clinocopathologic analysis of 32 cases suggesting a better prognostic subgroup among pleomorphic sarcomas. Am J Surg Pathol. 1994; 18:1213–23.

19. Spillane AJ, Fisher C, Thomas JM. Myxoid liposarcoma-the frequency and the natural history of nonpulmonary soft tissue metastases. Ann Surg Oncol. 1999; 6:389–94.

20. Kim HS, Lee JY, Yi SY, et al. Liposarcoma: exploration of clinical prognostic factors for risk based stratification of therapy. BMC Cancer. 2009; 9:205.

21. Antonescu CR, Ladanyi M. Myxoid liposarcoma. Fletcher CDM, Unni KK, Mertens F, editors. World Health Organization classification of tumors: pathology and genetics of tumors of soft tissue and bone. IARC Press. France: Lyon;2002. p. 40–3.

22. Kilpatrick SE, Doyon J, Choong PF, Sim FH, Nascimento AG. The clinicopathologic spectrum of myxoid and round cell liposarcoma. A study of 95 cases. Cancer. 1996; 77:1450–8.