TY - JOUR
T1 - Dedifferentiated liposarcoma in the extremity and trunk wall
T2 - A multi-institutional study of 132 cases by the Japanese Musculoskeletal Oncology Group (JMOG)
AU - Morii, Takeshi
AU - Anazawa, Ukei
AU - Sato, Chiaki
AU - Iwata, Shintaro
AU - Nakagawa, Makoto
AU - Endo, Makoto
AU - Nakamura, Tomoki
AU - Ikuta, Kunihiro
AU - Nishida, Yoshihiro
AU - Nakayama, Robert
AU - Udaka, Toru
AU - Kawamoto, Teruya
AU - Kito, Munehisa
AU - Sato, Kenji
AU - Imanishi, Jungo
AU - Akiyama, Toru
AU - Kobayashi, Hiroshi
AU - Nagano, Akihito
AU - Outani, Hidetatsu
AU - Toki, Shunichi
AU - Nishisho, Toshihiko
AU - Sasa, Keita
AU - Suehara, Yoshiyuki
AU - Kawano, Hirotaka
AU - Ueda, Takafumi
AU - Morioka, Hideo
N1 - Funding Information:
This research was supported by the Practical Research for Innovative Cancer Control from the Agency for Medical Research and Development (AMED) . The funders had no role in the study design, data collection, analysis, manuscript writing, or submitting the manuscript to publication.
Publisher Copyright:
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2023/2
Y1 - 2023/2
N2 - Background: Dedifferentiated liposarcoma occurs predominantly in the retroperitoneum. Given the paucity of cases, information on the clinical characteristics of this entity in the extremities and trunk wall is quite limited. In particular, the significance of preoperative evaluation and principles of intraoperative management of the different components, i.e., well-differentiated and dedifferentiated areas, are still to be defined. Methods: Clinical characteristics, treatment outcomes, and risk factors for poor oncological outcomes in cases of dedifferentiated liposarcoma in the extremity or trunk wall were analyzed by a retrospective, multicentric study. Results: A total of 132 patients were included. The mean duration from the initial presentation to dedifferentiation was 101 months in dedifferentiation-type cases. The 5-year local recurrence-free survival, metastasis-free survival, and disease-specific survival rates were 71.6%, 75.7%, and 84.7%, respectively. Among 32 patients with metastasis, 15 presented with extrapulmonary metastasis. A percentage of dedifferentiated area over 87.5%, marginal/intralesional margin, and R1/2 resection in the dedifferentiated area were independent risk factors for local recurrence. Dedifferentiated areas over 36 cm2, French Federation of Cancer Centers Sarcoma Group grade III, and intralesional or marginal resection were independent risk factors for metastasis. A dedifferentiated area over 77 cm2 and lung metastasis were independent risk factors for disease-specific mortality. Conclusions: The typical clinical characteristics of dedifferentiated liposarcoma in the extremity and trunk wall were reconfirmed in the largest cohort ever. The evaluation of the dedifferentiated area in terms of grade, extension, and pathological margin, together with securing adequate surgical margins, was critical in the management of this entity.
AB - Background: Dedifferentiated liposarcoma occurs predominantly in the retroperitoneum. Given the paucity of cases, information on the clinical characteristics of this entity in the extremities and trunk wall is quite limited. In particular, the significance of preoperative evaluation and principles of intraoperative management of the different components, i.e., well-differentiated and dedifferentiated areas, are still to be defined. Methods: Clinical characteristics, treatment outcomes, and risk factors for poor oncological outcomes in cases of dedifferentiated liposarcoma in the extremity or trunk wall were analyzed by a retrospective, multicentric study. Results: A total of 132 patients were included. The mean duration from the initial presentation to dedifferentiation was 101 months in dedifferentiation-type cases. The 5-year local recurrence-free survival, metastasis-free survival, and disease-specific survival rates were 71.6%, 75.7%, and 84.7%, respectively. Among 32 patients with metastasis, 15 presented with extrapulmonary metastasis. A percentage of dedifferentiated area over 87.5%, marginal/intralesional margin, and R1/2 resection in the dedifferentiated area were independent risk factors for local recurrence. Dedifferentiated areas over 36 cm2, French Federation of Cancer Centers Sarcoma Group grade III, and intralesional or marginal resection were independent risk factors for metastasis. A dedifferentiated area over 77 cm2 and lung metastasis were independent risk factors for disease-specific mortality. Conclusions: The typical clinical characteristics of dedifferentiated liposarcoma in the extremity and trunk wall were reconfirmed in the largest cohort ever. The evaluation of the dedifferentiated area in terms of grade, extension, and pathological margin, together with securing adequate surgical margins, was critical in the management of this entity.
KW - Dedifferentiated liposarcoma
KW - Extremity
KW - Prognosis
KW - Sarcoma
KW - Trunk wall
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U2 - 10.1016/j.ejso.2022.08.024
DO - 10.1016/j.ejso.2022.08.024
M3 - Article
C2 - 36088237
AN - SCOPUS:85137624656
SN - 0748-7983
VL - 49
SP - 353
EP - 361
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 2
ER -
