Characteristics of primary and repeated recurrent retroperitoneal liposarcoma: outcomes after aggressive surgeries at a single institution

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.

Survival outcomes of surgery for retroperitoneal sarcomas: A systematic review and meta-analysis

“…The PRISMA flow diagram showing the entire review process from the original search to the final selection of studies is presented in Fig 1 . In total, 17 studies (3875 participants) compared between extended resection and tumour resection alone [ 10 , 19 , 20 , 22 , 23 , 31 , 32 , 38 , 44 , 45 , 48 , 51 , 53 , 56 , 57 , 59 , 60 ]. Meanwhile, 26 studies (17368 patients) reported data on different surgical resection margins [ 12 , 17 , 18 , 20 , 21 , 24 – 28 , 33 – 36 , 40 – 43 , 46 , 47 , 49 , 50 , 52 , 54 , 55 , 61 ], and five studies (1619 participants) compared the long-term outcomes between surgery and conservative treatment in patients with recurrent RPS [ 29 , 30 , 37 , 39 , 58 ].…”

“…There were seven studies [ 20 , 31 , 32 , 38 , 45 , 48 , 53 ] (790 patients) that reported disease-free survival, and they were pooled in a random-effects model. The results showed no significant difference between the extended resection group and the tumour resection alone group (HR: 1.00; 95% CI: 0.74–1.27; P = 0.945; S1 File ), with low heterogeneity ( I 2 = 23%).…”

“…We pooled the results of 11 studies [ 19 , 31 , 32 , 38 , 44 , 45 , 51 , 53 , 56 , 59 , 60 ] (3014 patients) that reported HRs for OS. The results indicated no significant difference between the extended resection group and the tumour resection alone group (HR: 0.93; 95% CI: 0.83–1.03; P = 0.774; S1 File ), with no heterogeneity ( I 2 = 0%).…”

New Primary Vs True Recurrence In Relapsed Retroperitoneal Liposarcoma: An Analysis of Clinicopatholgical Characteristic Differences And Relapse-Free Survival

“…1). Relapse-free survival (RFS) was de ned as the time from surgery to the time of relapse diagnosis [13] .…”

Prediction of intraoperative bleeding and blood transfusion in patients with recurrent retroperitoneal liposarcoma: a retrospective study

“…Surgical resection is the mainstay of therapy for RPLS and is the only curative treatment available (2,3,7), and the roles of radiotherapy and chemotherapy in the management of RPLS remain controversial (8)(9)(10)(11)(12)(13). Although RPLS metastasis is uncommon, local tumor recurrence occurs in >50% of patients after surgery (14,15). Moreover, 70% of RPLSrelated deaths are due to local recurrence rather than distant metastasis or other reasons (8,16).…”