Efficacy of surgery in the management of multiple recurrences of retroperitoneal dedifferentiated liposarcoma.
Recurrent cases
Retroperitoneal dedifferentiated liposarcoma
SUVmax values
Surgery
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
05 Oct 2024
05 Oct 2024
Historique:
received:
03
06
2024
accepted:
01
10
2024
medline:
6
10
2024
pubmed:
6
10
2024
entrez:
5
10
2024
Statut:
epublish
Résumé
Retroperitoneal dedifferentiated liposarcoma is associated with a high risk of recurrence; however, treatment strategies that are more effective than surgery remain to be established. This study aimed to determine the optimal number of surgeries that would be effective for patients with recurrent disease. Furthermore, the improvement in prognosis was evaluated according to the malignancy level. The effect of each type of surgery on the prognosis of 118 patients with retroperitoneal dedifferentiated liposarcoma treated at the Osaka International Cancer Institute between 1997 and 2022 was investigated. Among the 118 patients, 103 underwent initial surgery, while 54 and 30 patients underwent second and third surgeries, respectively. The overall and disease-free survival rates of each group were compared using the Kaplan-Meier method, and the log-rank test was used to determine statistical significance in univariate analysis. The first and second surgeries resulted in a significant improvement in the overall survival rate, regardless of the malignancy level (p < 0.001); however, no significant improvement in prognosis was observed after the third surgery (p = 0.077). Low-grade malignancies are associated with a better postoperative prognosis, even in cases of recurrence. In contrast, high-grade malignancies exhibit a reduction in surgical efficacy. This study highlights the importance of considering the tumor malignancy level and the patient's overall condition when deciding whether to perform repeated surgical interventions. Surgical treatment can prolong overall survival, even in patients with recurrence; however, it is advisable to assess malignancy levels when determining the suitability of surgery beyond the second recurrence.
Sections du résumé
BACKGROUND
BACKGROUND
Retroperitoneal dedifferentiated liposarcoma is associated with a high risk of recurrence; however, treatment strategies that are more effective than surgery remain to be established. This study aimed to determine the optimal number of surgeries that would be effective for patients with recurrent disease. Furthermore, the improvement in prognosis was evaluated according to the malignancy level.
METHODS
METHODS
The effect of each type of surgery on the prognosis of 118 patients with retroperitoneal dedifferentiated liposarcoma treated at the Osaka International Cancer Institute between 1997 and 2022 was investigated. Among the 118 patients, 103 underwent initial surgery, while 54 and 30 patients underwent second and third surgeries, respectively. The overall and disease-free survival rates of each group were compared using the Kaplan-Meier method, and the log-rank test was used to determine statistical significance in univariate analysis.
RESULTS
RESULTS
The first and second surgeries resulted in a significant improvement in the overall survival rate, regardless of the malignancy level (p < 0.001); however, no significant improvement in prognosis was observed after the third surgery (p = 0.077). Low-grade malignancies are associated with a better postoperative prognosis, even in cases of recurrence. In contrast, high-grade malignancies exhibit a reduction in surgical efficacy.
CONCLUSIONS
CONCLUSIONS
This study highlights the importance of considering the tumor malignancy level and the patient's overall condition when deciding whether to perform repeated surgical interventions. Surgical treatment can prolong overall survival, even in patients with recurrence; however, it is advisable to assess malignancy levels when determining the suitability of surgery beyond the second recurrence.
Identifiants
pubmed: 39369260
doi: 10.1186/s12957-024-03552-w
pii: 10.1186/s12957-024-03552-w
doi:
Substances chimiques
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
265Informations de copyright
© 2024. The Author(s).
Références
Thway K. Well-differentiated liposarcoma and dedifferentiated liposarcoma: an updated review. Semin Diagn Pathol. 2019;36:112–21. https://doi.org/10.1053/j.semdp.2019.02.006 .
doi: 10.1053/j.semdp.2019.02.006
pubmed: 30852045
Montgomery E, Fisher C. Paratesticular liposarcoma: a clinicopathologic study. Am J Surg Pathol. 2003;27:40–7. https://doi.org/10.1097/00000478-200301000-00005 .
doi: 10.1097/00000478-200301000-00005
pubmed: 12502926
Boland JM, Colby TV, Folpe AL. Liposarcomas of the mediastinum and thorax: a clinicopathologic and molecular cytogenetic study of 24 cases, emphasizing unusual and diverse histologic features. Am J Surg Pathol. 2012;36:1395–403. https://doi.org/10.1097/PAS.0b013e3182562bc1 .
doi: 10.1097/PAS.0b013e3182562bc1
pubmed: 22895273
Matthyssens LE, Creytens D, Ceelen WP. Retroperitoneal liposarcoma: current insights in diagnosis and treatment. Front Surg. 2015;2:4. https://doi.org/10.3389/fsurg.2015.00004 . Published online.
doi: 10.3389/fsurg.2015.00004
pubmed: 25713799
pmcid: 4322543
Laco J, Mentzel T, Hornychova H, Kohout A, Jirousek Z, Ryska A. Atypical lipomatous tumors of the tongue: report of six cases. Virchows Arch. 2009;455:383–8. https://doi.org/10.1007/s00428-009-0835-6 .
doi: 10.1007/s00428-009-0835-6
pubmed: 19816710
Clay MR, Martinez AP, Weiss SW, Edgar MA. MDM2 and CDK4 immunohistochemistry: should it be used in problematic differentiated lipomatous tumors?: a new perspective. Am J Surg Pathol. 2016;40:1647–52. https://doi.org/10.1097/PAS.0000000000000713 .
doi: 10.1097/PAS.0000000000000713
pubmed: 27508976
MacNeill AJ, Miceli R, Strauss DC, Bonvalot S, Hohenberger P, Van Coevorden F, et al. Post-relapse outcomes after primary extended resection of retroperitoneal sarcoma: A report from the trans-Atlantic RPS working group. Cancer. 2017;123:1971–8. https://doi.org/10.1002/cncr.30572 .
doi: 10.1002/cncr.30572
pubmed: 28152173
Wakamatsu T, Imura Y, Tamiya H, Yagi T, Yasuda N, Nakai S, et al. 18F-fluorodeoxyglucose positron emission tomography is useful in the evaluation of prognosis in retroperitoneal sarcoma. Cancers. 2021;13:4611. https://doi.org/10.3390/cancers13184611 .
doi: 10.3390/cancers13184611
pubmed: 34572838
pmcid: 8471941
Trojani M, Contesso G, Coindre JM, Rouesse J, Bui NB, De Mascarel A, et al. Soft-tissue sarcomas of adults; study of pathological prognostic variables and definition of a histopathological grading system. Int J Cancer. 1984;33(1):37–42. https://doi.org/10.1002/ijc.291033010 .
doi: 10.1002/ijc.291033010
pubmed: 6693192
Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: 5-year experience. Ann Surg. 2009;250:187–96. https://doi.org/10.1097/SLA.0b013e3181b13ca2 .
doi: 10.1097/SLA.0b013e3181b13ca2
pubmed: 19638912
Bowers J, Komorowski A, Stone P. Assessment of postoperative complications using the Clavien-Dindo classification: A systematic review and meta-analysis. J Surg Res. 2018;229:53–60. https://doi.org/10.1016/j.jss.2018.03.070 .
doi: 10.1016/j.jss.2018.03.070
Thompson C, White J, Baker R. The role of the Evans-Pridon classification in the management of soft tissue sarcomas: a clinical review. Sarcoma. 2013:Article ID 217564. https://doi.org/10.1155/2013/217564 .
Giuliano K, Nagarajan N, Canner JK, et al. Predictors of improved survival for patients with retroperitonealsarcoma. Surgery. 2016;160:1628–35. https://doi.org/10.1016/j.surg.2016.05.041 .
doi: 10.1016/j.surg.2016.05.041
pubmed: 27495850
Garcia-Ortega DY, Villa-Zepeda O, Martinez-Said H, Cuellar-Hübbe M, Luna-Ortiz K. Oncology outcomes inretroperitoneal sarcomas: prognostic factors in a retrospective cohort study. Int J Surg. 2016;32:459. https://doi.org/10.1016/j.ijsu.2016.06.001 .
doi: 10.1016/j.ijsu.2016.06.001
Kirane A, Crago AM. The importance of surgical margins in retroperitoneal sarcoma. Journal of Surgical Oncology. 2016;113(3):270–6. https://doi.org/10.1002/jso.24135 .
doi: 10.1002/jso.24135
pubmed: 26707028
Bonvalot S, Rivoire M, Castaing M, Stoeckle E, Le Péchoux C, et al. Outcome of surgical resection for retroperitoneal sarcoma in a single tertiary care center. Ann Surg. 2010;251(3):485–92. https://doi.org/10.1097/SLA.0b013e3181c27a1a .
doi: 10.1097/SLA.0b013e3181c27a1a
Liles JS, Tzeng CWD, Short JJ, Kulesza P, Heslin MJ. Retroperitoneal and intra-abdominal sarcoma. Curr Probl Surg. 2009;46:445–503. https://doi.org/10.1067/j.cpsurg.2009.01.004 .
doi: 10.1067/j.cpsurg.2009.01.004
pubmed: 19414097
Bonvalot S, Rivoire M, Castaing M, Stoeckle E, Le Cesne A, Blay JY, et al. Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol. 2009;27:31–7. https://doi.org/10.1200/JCO.2008.18.0802 .
doi: 10.1200/JCO.2008.18.0802
pubmed: 19047280
Dario C, Chandrajit R, Taiwo A, Dirk S, Sylvie B, Deanna N. Preoperative radiotherapy in patients with primary retroperitoneal sarcoma EORTC-62092 Trial (STRASS) versus off-trial (STREXIT) results. Annal Surg. 2023;278(1):127–34. https://doi.org/10.1097/SLA.0000000000005492 .
doi: 10.1097/SLA.0000000000005492
Mohindra P, Neuman HB, Kozak KR. The role of radiation in retroperitoneal sarcomas. Curr Treat Options Oncol. 2013;14:425–41. https://doi.org/10.1007/s11864-013-0236-6 .
doi: 10.1007/s11864-013-0236-6
pubmed: 23649911
pmcid: 3769487
Constantinidou A, Pollack S, Loggers E, Rodler E, Jones RL. The evolution of systemic therapy in sarcoma. Expert Rev Anticancer Ther. 2013;13:211–23. https://doi.org/10.1586/era.12.161 .
doi: 10.1586/era.12.161
pubmed: 23406562
Kus T, Aktas G, Kalender ME, Tutar E, Ulker E, Camci C. Complete response of a recurrent-metastatic lipo2sarcoma with dedifferentiated histological features following the administration of trabectedin and review of literature. J Cancer Res Ther. 2015;11:974–6. https://doi.org/10.4103/0973-1482.158032 .
doi: 10.4103/0973-1482.158032
pubmed: 26881560
Paioli A, Setola E, Palmerini E, Cesari M, Longhi A. Experience with eribulin in pretreated patients with advanced liposarcoma: a case series. Future Oncol. 2019;20. https://doi.org/10.2217/fon-2019-0599 .
De Sanctis R, Marrari A, Marchetti S, Mussi C, Balzarini L, Lutman FR, et al. Efficacy of trabectedin in advanced soft tissue sarcoma: beyond lipo- and leiomyosarcoma. Drug Des Devel Ther. 2015;9:5785–91. https://doi.org/10.2147/DDDT.S92395 .
doi: 10.2147/DDDT.S92395
pubmed: 26604682
pmcid: 4629957
Issels RD, Lindner LH, Verweij J, Wust P, Reichardt P, Schem BC, et al. Neo-adjuvant chemotherapy alone or with regional hyperthermia for localized high-risk soft-tissue sarcoma: a randomized phase 3 multicenter study. Lancet Oncol. 2010;11:561–70. https://doi.org/10.1016/S1470-2045(10)70071-1 .
doi: 10.1016/S1470-2045(10)70071-1
pubmed: 20434400
pmcid: 3517819
Jones RL, Fisher C, Al-Muderis O, Judson IR. Differential sensitivity of liposarcoma subtypes to chemotherapy. Eur J Cancer. 2005;41:2853–60. https://doi.org/10.1016/j.ejca.2005.07.023 .
doi: 10.1016/j.ejca.2005.07.023
pubmed: 16289617
Houdt WJ, Raut CP, Bonvalot S, Swallow CJ, Haas R, Gronchi A. New research strategies in retroperitoneal sarcoma. The case of TARPSWG, STRASS and RESAR: making progress through collaboration. Curr Opin Oncol. 2019;31(4):310–6. https://doi.org/10.1097/CCO.0000000000000535 .
doi: 10.1097/CCO.0000000000000535
pubmed: 30893150
Koyama T, Shimizu T, Kojima Y, Sudo K, Sumiyoshi H, Tatsunori O, et al. Clinical activity and exploratory resistance mechanism of milademetan, an MDM2 Inhibitor, in intimal sarcoma with MDM2 Amplification: An open-label phase Ib/II study. Cancer Discov. 2023;13:1814–25. https://doi.org/10.1158/2159-8290.CD-23-0419 .
doi: 10.1158/2159-8290.CD-23-0419
pubmed: 37369013
MacNeill AJ, Gronchi A, Miceli R, Bonvalot S, Swallow CJ, Hohenberger P, et al. Postoperative morbidity after radical resection of primary retroperitoneal sarcoma. Ann Surg. 2018;267:959–64. https://doi.org/10.1097/SLA.0000000000002250 .
doi: 10.1097/SLA.0000000000002250
pubmed: 28394870
Tirotta F, Parente A, Hodson J, Desai A, Almond LM, Ford SJ. Cumulative burden of postoperative complications in patients undergoing surgery for primary retroperitoneal sarcoma. Ann Surg Oncol. 2021;28:7939–49. https://doi.org/10.1245/s10434-021-10059-1 .
doi: 10.1245/s10434-021-10059-1
pubmed: 33978886