Efficacy of neoadjuvant hypofractionated radiotherapy in patients with locally advanced myxoid liposarcoma

Koseła-Paterczyk, Hanna; Szumera‐Ciećkiewicz, Anna; Szacht, Milena; Haas, Rick L.; Morysiński, Tadeusz; Dziewirski, Wirginiusz; Prochorec‐Sobieszek, Monika; Rutkowski, Piotr

doi:10.1016/j.ejso.2016.02.258

Cited by 29 publications

(19 citation statements)

References 32 publications

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“…In this study, we presented a relatively large group of patients with primary MLPS in the extremities treated by surgery with or without adjuvant treatments in our hospital. Although the clinical efficacy of chemotherapy based on doxorubicin and ifosfamide and radiotherapy has been reported in the treatment of MLPS, tumor resection was the first treatment choice in this study. The resection margin is considered one of the most important factors affecting survival in soft tissue sarcoma patients.…”

Section: Discussionmentioning

confidence: 93%

“…Local recurrence and metastasis to atypical sites, such as bone, retroperitoneum, or lymph nodes, are also commonly encountered. The treatment options for soft tissue sarcoma consist of tumor resection, neoadjuvant chemotherapy, adjuvant chemotherapy, and radiotherapy. The roles of chemotherapy and radiotherapy in treating localized soft tissue sarcoma remain controversial.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Outcomes and Prognostic Factors of Myxoid Liposarcoma in Extremities: A Retrospective Study

Zheng¹,

Yu²,

Xu³

et al. 2019

Orthopaedic Surgery

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ObjectivesTo evaluate treatments and prognostic factors for the myxoid liposarcoma in extremities.MethodsWe retrospectively reviewed 34 patients histologically diagnosed with myxoid liposarcoma arising in the extremities, treated in our hospital from 2010 to 2017. We recorded tumor locations, max diameter, operations, complications, radiation, chemotherapy, survival, recrudescence, and metastases. Overall survival, treatments, and prognostic factors were subsequently analyzed.ResultsThe mean age of 34 patients with myxoid liposarcoma in extremities was 49.1 years, and the mean follow‐up period was 65.1 months. The median survival time was 190 months. Five of 14 patients accepted recrudescence resection and two patients of 20 patients who underwent primary tumor resection or unplanned operation died of tumor progression. Although no statistical difference was found (X 2 = 3.331, P = 0.068), the lower mortality was confirmed in the patients who accepted primary tumor resection or unplanned operation. Eleven patients with a tumor diameter of 8.6 ± 4.7 cm accepted wide resection, while 23 patients with 17.2 ± 8.8 cm tumors accepted marginal resection. Statistical difference was found between the size of tumors with relatively wide resection and those with relatively marginal resection (F = 9.130, P = 0.005). No recurrence or metastasis occurred in patients who accepted wide resection, while 14 patients presented with local recurrence and 8 patients developed distant metastases among the 23 patients with marginal resection. Seven patients died of metastases, while one patient lived with metastases. No significant difference in survival was found between different surgical methods (X 2 = 0.9460, P = 0.3307). The average diameter of eight patients with distant metastases was 21.7 cm, which was considerable larger than the 12.1 cm of patients without metastasis. This difference was proven significant upon the statistical analysis (F = 9.412, P = 0.004).ConclusionsWide resection achieved good local control but was not unambiguously superior in long‐term survival. Myxoid liposarcoma tumors with larger diameters were more difficult to be submitted to wide resection and were more likely to present with distant metastasis.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Surgical Outcomes and Prognostic Factors of Myxoid Liposarcoma in Extremities: A Retrospective Study

Zheng¹,

Yu²,

Xu³

et al. 2019

Orthopaedic Surgery

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“…Using radiotherapy in marginal or even intralesional resections in 10 patients the addition of radiotherapy resulted in no local relapse at a mean follow-up of 58 months [ 33 ]. Even in a hypofractionated protocol (5 × 5 Gy followed by immediate surgery) in 32 patients a 5-year LR of 10% was achieved [ 34 ]. In many other retrospective studies, as in ours, in which radiation is part of therapy in selected cases a strong bias with more relevant risk factors in patients in the radiotherapy group might influence the result.…”

Section: Discussionmentioning

confidence: 99%

Myxoid liposarcoma: local relapse and metastatic pattern in 43 patients

Dürr¹,

Rauh²,

Baur‐Melnyk³

et al. 2018

BMC Cancer

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BackgroundLiposarcomas are the second most common type of soft tissue sarcomas, 30–50% of these are of myxoid subtype. The aim of this retrospective study was to analyze the local control rate, the metastatic pattern and survival of patients in a consecutive single-institution series.MethodsFrom 1983 to 2015, 43 patients with myxoid liposarcoma of the extremities and trunk wall underwent resections. The margin was defined as R0 (wide) or R1 (marginal). Patients were followed for evidence of local recurrence or distant metastasis. Overall and recurrence-free survival was calculated.ResultsThe mean age was 48.6 years. The lower extremity was involved in 40 cases, the mean tumour size was 12 cm. In 31 cases a wide and in 12 cases a marginal resection was performed. Grading was G1 in 14, G2 in 25 and G3 in 4 cases.Nine patient died in follow-up, 4 of them with metastatic disease, all nonpulmonary. 5-year local recurrence (LR) free survival was 82%. 4 (9.3%) patients developed LR (all R1). Overall survival (OS) was 81% after 5 and 72% after 10 years. In multivariate analysis age and Grading proved to be significant on OS. According to univariate analysis, only age over 48 years and distant metastasis had a significant impact on overall survival.ConclusionsPatients with myxoid liposarcomas have a good prognosis. Myxoid liposarcoma has a distinct pattern of nonpulmonary metastatic disease. Therefore, patients with high-risk extremity myxoid liposarcoma should undergo imaging studies of the chest, abdomen, spine and pelvis as part of their staging and follow-up examinations preferably with whole body MRI, or CT scans and MRI of the spine and pelvic region for detection of suspected metastatic disease.

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“…There are reports of the substantial decrease in the volume of lesions and also histological features of response to radiation treatment such as induction of adipogenesis [11,12]. Furthermore, in MLPS patients treated with the aforementioned hypofractionated RT regimen, pathological response to therapy was observed despite the very short gap between the RT completion and surgery, i.e., between two and seven days [13].…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated Radiotherapy in Locally Advanced Myxoid Liposarcomas of Extremities or Trunk Wall: Results of a Single-Arm Prospective Clinical Trial

Koseła-Paterczyk

Spałek

Borkowska

et al. 2020

JCM

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Introduction: Myxoid liposarcoma (MLPS) has been reported to be more radiosensitive compared with other soft tissue sarcomas. The main objective of the study was to assess the efficacy of hypofractionated radiotherapy (RT) in the preoperative setting in patients with locally advanced primary MLPS. Methods: Single-arm prospective exploratory clinical trial enrolled MLPS patients for preoperative 5 × 5 Gy RT with delayed surgery. The endpoints of the study were the rate of early wound healing complications and 5-year local control rate. Results: 29 patients (pts) were included, all had tumors located on the lower limb. The median maximum size of the tumor was 13 cm (IQR 10–15 cm). Early RT tolerance was good. Postoperative wound complications occurred in 11 pts (37.9%), late complications concerned 13.8% of patients. A total of 27 patients were included for the efficacy analyses. The pathological features of response to RT were detected in all analyzed surgical specimens. In 25 patients R0 margins were achieved, two patients had an R1 resection. None of the patients had local recurrence. Conclusion: Preoperative hypofractionated RT with a prolonged gap between RT and surgery is a feasible method of the management of MLPS, providing a good local control and low rates of treatment toxicity.

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Efficacy of neoadjuvant hypofractionated radiotherapy in patients with locally advanced myxoid liposarcoma

Cited by 29 publications

References 32 publications

Surgical Outcomes and Prognostic Factors of Myxoid Liposarcoma in Extremities: A Retrospective Study

Surgical Outcomes and Prognostic Factors of Myxoid Liposarcoma in Extremities: A Retrospective Study

Myxoid liposarcoma: local relapse and metastatic pattern in 43 patients

Hypofractionated Radiotherapy in Locally Advanced Myxoid Liposarcomas of Extremities or Trunk Wall: Results of a Single-Arm Prospective Clinical Trial

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