Surgical Diagnosis and Treatment of Primary Retroperitoneal Liposarcoma

Abstract

Background: Primary retroperitoneal liposarcoma (PRPLS) is the most common soft tissue sarcoma of the retroperitoneum with high recurrence rate and short overall survival (OS).Methods: A retrospective review of 51 patients with PRPLS, treated between September 1, 2009 and November 30, 2020, was conducted to evaluate clinical outcomes of PRPLS resection. Patient demographics, histopathologic subtypes, overall survival (OS), progression-free survival (PFS), disease recurrence rate, and tumor stage were reviewed and analyzed. Univariate analysis was done to identify factors potentially affecting OS and PFS of PRPLS patients. Multivariate Cox proportional hazards analysis was used to evaluate the impact of various clinicopathological factors on OS and PFS of PRPLS patients.Results: Fifty-one PRPLS patients (28 Males, 23 Females; mean age 56.25 years) were evaluated. There was no significant effect of age, gender, contiguous organ resection, degree of differentiation and tumor size on the OS and PFS of the patients. Univariate analysis showed that negative surgical margin and early tumor stage significantly correlated with OS and PFS (all P < 0.001). Multivariate analysis showed that tumor stage [hazard ratio (HR) = 1.177, P = 0.001] was an independent predictors of poor progression-free survival, and surgical margins [HR = 4.0674 P = 0.038] and tumor stage [HR = 1.167 P = 0.001] were identified as independent predictors of poor overall survival.Conclusion: Negative surgical margin is a prognostic factor of OS, and can prolong the postoperative survival time of PRPLS patients. Tumor stage is a prognostic factor for OS and PFS, and can influence the survival of PRPLS patients. Earlier tumor stages of PRPLS are associated with significantly better outcomes.

Extended surgical resection for primary retroperitoneal sarcoma. Systematic review and meta- analysis

“…Concomitant organ resection was not associated with better DFS (HR 1.022, 95% CI 0.537 to 1.946, P value 0.946). Retrospective hospital studies of Asian populations reached similar conclusions (39,40) and (Table 4). Table 4 outlines the studies investigating contiguous organ resection in retroperitoneal liposarcomas.…”

Phosphorylation of IWS1 by AKT maintains liposarcoma tumor heterogeneity through preservation of cancer stem cell phenotypes and mesenchymal-epithelial plasticity

“…While rare, retroperitoneal liposarcomas (LPS) are locally aggressive tumors that present significant clinical challenges and are associated with a dismal prognosis [ 1 , 2 ]. Surgical resection remains the only chance for long-term survival [ 3 , 4 ].…”

Giant Retroperitoneal Liposarcoma: Correlation Between Size and Risk for Recurrence

“…Singer et al [ 34 ] have demonstrated that tumor histology type, tumor grade and contiguous organ resection were significantly associated with tumor recurrence, while tumor size was not an independent risk factor. A retrospective study by Chen et al [ 36 ], including 51 patients with primary RPL, showed that tumor size was not an independent risk factor for recurrence or prognosis on univariate and multivariate analysis. The findings of the previous studies including our review exclude tumor size as a prognostic factor for tumor recurrence.…”