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

Abstract

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.

Surgery Treatment Improved the Overall Survival Rate in Locoregional Myxoid Leiomyosarcoma than Other Myxosarcomas in the United States

“…Locoregional metastatic myxoid liposarcoma treatment data are extracted from SEER during 1975-2016, including surgery, radiotherapy, and chemotherapy modalities. Most of the reported cases in the SEER of locoregional metastatic patients with myxoid liposarcoma were performed surgery which is almost 95.2% of the total number of patients, and this result was similar as in the literature [ 38 ]. Radiotherapy treatments of patients with locoregional myxoid liposarcoma of data obtained from SEER showed no big difference between received beam radiations versus unreceived patients, almost 47.1% versus 52.9%.…”

Rare case of metastatic liposarcoma to the thyroid gland and a review of the literature of metastatic sarcomas to the thyroid

“…As a consequence of their favorable response to treatment, myxoid liposarcomas have a good prognosis 1 . However, tumor size, positive surgical margins, and local recurrence are all associated with lower rates of disease‐free survival and overall survival 51‐53 . Our case highlights the role of a patient's medical history when evaluating thyroid nodules to optimize accurate diagnosis, as liposarcomas do not typically present in the thyroid gland.…”

Management of myxoid liposarcoma of the extremity (Review)

“…Orson et al ( 33 ) and Reitan et al ( 34 ) both demonstrated that larger tumors were associated with poorer prognosis. Moreover, four larger studies ( 7 , 15 , 18 , 20 ) assessed several prognostic factors for MLPS with varying results. One study showed that tumors >5 cm were associated with worse DSS compared with those <5 cm ( 17 ).…”

“…Surgical resection remains the first-line treatment for almost all cases of STS, including primary MLPS of the extremities, with the exception of some diffusely metastatic conditions ( 7 , 47 , 48 ). Historically, amputation was once considered the standard therapy to attain local control in patients with extremity STS ( 49 ).…”

“…Surgical resection with adjuvant radiotherapy (RT) and possible chemotherapy is the primary management option for MLPS ( 5 , 7 ). Several studies have investigated the clinical management outcomes of MLPS, but could not identify a single, unified strategy ( 5 , 7 ). Lack of a well-defined protocol increases the risk of local and distant relapses, negatively impacting patient overall survival (OS) ( 6 ).…”