A better overall survival (OS) for total (ipsilateral) retroperitoneal lipectomy than standard complete resection in patients with retroperitoneal liposarcoma: a comparative multi-institutional study

Abstract

Background: Complete resection (CR) serves as the standard of surgical treatment for retroperitoneal liposarcoma (RPLS). Unfortunately, even at referral centers, recurrence rates are high, and CR may not address multifocal diseases, which are a common phenomenon in RPLS. We sought to retrospectively compare the clinical outcomes of RPLS patients treated with total (ipsilateral) retroperitoneal lipectomy (TRL) and CR. Because TRL remove potentially multifocal tumors in the fat, patients may have a better prognosis than CR.Methods: Patients with primary/first-recurrent RPLS who had been treated at 5 referral centers were recruited from December 2014 to June 2018. Multivariable Cox regression analyses were conducted to determine the effects of demographic, operative, and clinicopathological variables on the following primary endpoints: local recurrence (LR), local recurrence-free survival (LRFS), and overall survival (OS).Results: A total of 134 patients were enrolled in this retrospective study, 53 of whom underwent TRL, and 81 of whom underwent CR. The 2 groups were comparable in terms of age, gender, presentation (primary vs. first-recurrent RPLS), number of tumors (unifocal vs. multifocal) at presentation, and Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade. The TRL group had higher levels of preoperative hemoglobin (Hb) (13 vs. 12.5 g/dL; P=0.008) and a lower amount of intraoperative blood loss (400 vs. 500 mL; P=0.034), but there were no significant differences in the length of hospital stay (23 vs. 22 d; P=0.47) or complications (32 vs. 30; P=0.82) between the 2 groups. In a subset of patients with multifocal tumors at initial presentation, OS was more prolonged in those treated with TRL than those treated with CR (P=0.0272). Based on the multivariable analysis, primary liposarcoma and a low FNCLCC grade were associated with decreased LR and improved OS.Conclusions: TRL is a safe procedure that positively affects the OS of patients with multifocal RPLS. This novel strategy deserves further investigation in prospective studies.

Predictive factors and a novel nomogram for recurrence of primary retroperitoneal liposarcoma: Comprehensive analysis of 128 cases

“…Multivariate analysis - ---------------------------------------------------------------------------------------------------------------------------------------- organs, resulting in non-specific clinical symptoms, such as abdominal pain and distension, gastrointestinal obstruction, back pain and lower limb paresthesia (17). Piecemeal resection was considered only when complete resection was impossible to complete and piecemeal resection also increased the risk of intraoperative bleeding and tumor cell dissemination (12,20). Furthermore, prolonged operative time increases the exposure time, possibility of injury and degree of edema in tissues, leading to an increased risk of intraoperative bleeding and transfer to ICU.…”

Near-Infrared-Mediated Self-Assembly of Graphene Quantum Dot-Based Nanoprobes to Silence Heat Shock Protein Expression for Mild Photothermal Therapy in Liposarcoma

“…4 Surgical resection is the only effective treatment for retroperitoneal liposarcoma at present, but it is prone to local recurrence. 5 Conventional systemic chemotherapy and targeted therapy have limited and short-lived effects, are prone to drug resistance, and are often accompanied by severe hematologic toxicity. 6 Recently, nanomaterials-based technology has rapidly developed and several novel nanosystems have been developed for early diagnosis and precise treatment of diseases.…”

“…Retroperitoneal liposarcoma, in particular, is a type of tumor originating from nonspecific organs of retroperitoneal adipose tissue. , Due to the insidious nature of its onset, retroperitoneal liposarcoma is difficult to detect in a small area and is not apparent to patients until the tumor becomes large and invades or compresses surrounding organs, causing symptoms . Surgical resection is the only effective treatment for retroperitoneal liposarcoma at present, but it is prone to local recurrence . Conventional systemic chemotherapy and targeted therapy have limited and short-lived effects, are prone to drug resistance, and are often accompanied by severe hematologic toxicity …”

Case report of preoperative radiotherapy followed by surgery in patient with giant primary retroperitoneal G1 liposarcoma

“…Больным с забрюшинными саркомами чаще всего выполняются агрессивные мультивисцеральные резекции. С одной стороны операции такого объёма травматичны и сопровождаются высокой частотой послеоперационных осложнений (31 %, [3]), с другой -именно такой подход считается радикальным.…”