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

Abstract

Since primary retroperitoneal liposarcoma (PRPLS) is rare in the clinic, related clinical studies are lacking. The present study was designed to investigate the predictive factors of short-term (≤1 year) recurrence (STR) and construct a novel nomogram of local recurrence-free survival (LRFS) for surgically resected PRPLS. A total of 128 PRPLS cases who underwent radical surgery were retrospectively analyzed. Based on the interval from the operation to tumor recurrence, the predictors of STR were screened using univariate and multivariate logistic regression analyses. Cox proportional hazard regression models were applied to identify the predictors of LRFS. Furthermore, the independent predictors acquired from multivariate analyses were used to construct a nomogram. Multivariate logistic regression analysis revealed that age ≥55 years [odds ratio (OR)=5.607, P=0.010], operative time ≥260 min (OR=9.716, P=0.005) and tumor necrosis (OR=3.781, P=0.037) were independent risk factors of STR for PRPLS. In the Cox regression analysis, clinical symptoms [hazard ratio (HR)=1.746, P=0.017], resection method (OR=0.370, P=0.021) and de-differentiated histological subtype (HR=1.975, P=0.048) were identified as independent predictors of LRFS. Subsequently, the independent predictors acquired from multivariate analyses were used to construct a nomogram for LRFS. Age, operative time, tumor necrosis, clinical symptoms, resection method and histological subtype were related to recurrence for surgically resected PRPLS and a novel nomogram was constructed based on the above predictors.

Surgical management of giant retroperitoneal liposarcoma: Case report

“…Therefore, piecemeal resection should be avoided since it also increases tumor cell dissemination and the procedure duration which is also an important predictor for 1-year recurrences. 16 …”

“…Adjuvant and neoadjuvant therapy is controversial. 16 Neoadjuvant chemotherapy (doxorubicin, alkylating agents) is indicated only in locally advanced or metastatic tumors, where it can reduce tumor volume therefore improving surgical performances. 11 Radiotherapy has been shown to significantly reduce the risk of local recurrence 19 at the cost of increased gastric and enteric morbidity (radiation-induced gastroenteritis, gastro-enteric fistulas, intestinal occlusions), which may require additional surgery.…”