Surgical outcomes for liposarcoma of the lower limbs with synchronous pulmonary metastases

Ceccanei, Gianluca; Pacilè, Maria Antonietta; Caliò, Francesco G.; Migliano, Francesco; Mercurio, Valentina; Pizzardi, Giulia; Nigri, Giuseppe

doi:10.1002/jso.21706

Cited by 6 publications

(1 citation statement)

References 27 publications

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“…A few studies have examined the effect of interventions on patients with bone and soft-tissue sarcoma with distant metastasis. Although some have shown that resection of the distant metastasis improves the prognosis (2,8,(15)(16)(17), only a few reports have examined the effects of primary lesion resection (4, 5). Nakamura et al showed that prognosis improved after primary lesion excision, but this was through a univariate analysis and they did not examine the treatment for distant metastatic lesions (7).…”

Section: Discussionmentioning

confidence: 99%

Impact of Primary Tumor Resection on Metastasis to the Lung in Patients With Bone and Soft-tissue Sarcoma

Tsuchie

Emori

Nagasawa

et al. 2021

In Vivo

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Background: Few reports have investigated the effect of primary tumor resection on lung metastasis and prognosis in patients with bone and soft-tissue sarcoma, and we evaluated its effect on lung metastasis and prognosis. Patients and Methods: We retrospectively identified patients with lung metastasis from bone and soft-tissue sarcoma. We examined the factors affecting prognosis and the rate of lung metastasis increase. Results: A total of 48 patients were included. The multivariate analysis revealed that poor prognosis was significantly associated with a large maximum diameter of lung metastasis at the first visit and a rapid rate of increase (p=0.0400 and p=0.0003, respectively). The multivariate logistic regression analysis revealed that the rate of increase of size of lung metastases was only significantly associated with a large maximum diameter at the first visit (p=0.0245). Conclusion: Primary tumor resection of bone and soft-tissue sarcoma in patients with lung metastasis was not shown to affect their prognosis.Bone and soft-tissue sarcomas, although relatively rare diseases, have various histological subtypes, including liposarcoma, synovial sarcoma, osteosarcoma, and Ewing sarcoma. Treatment is based on radical resection with adequate margins, regardless of the histological subtype, in order to prevent local recurrence. However, there is a consensus that the presence of distant metastases, particularly in the lungs, strongly influences prognosis (1-3). Chemotherapy is commonly used in patients with bone and soft-tissue sarcomas with lung metastases, especially those with numerous ones. The primary tumor is not aggressively resected in these patients. However, if the primary tumor interferes significantly with the patient's quality of life in terms of pain, neuropathy, and breaking of the skin, resection or even amputation may be required. Therefore, it is possible to remove only the primary tumor in these patients.In recent years, prognosis has been shown to improve in certain malignancies, such as gastric and colorectal cancer with multiple metastases, when the primary tumor is removed (4-6). However, very few reports have investigated the effect of primary tumor resection on the prognosis of patients with bone and soft-tissue sarcomas with distant metastases (7,8). Furthermore, to our knowledge, no reports have examined how excision of the primary tumor affects metastasis to the lungs, which is the most common type. This study aimed to examine the impact of primary tumor resection on lung metastasis and prognosis in patients with bone and soft-tissue sarcoma. Patients and MethodsPatients. We retrospectively identified patients with bone and softtissue sarcoma involving the extremities or trunk with lung metastasis at the first visit treated at our two hospitals between 1994 and 2020. Patients with lung metastasis confirmed at the same time as local primary tumor recurrence were also included. Since we aimed to assess the impact of primary tumor treatment, those who did not receive radiotherapy or sur...

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Section: Discussionmentioning

confidence: 99%

Impact of Primary Tumor Resection on Metastasis to the Lung in Patients With Bone and Soft-tissue Sarcoma

Tsuchie

Emori

Nagasawa

et al. 2021

In Vivo

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Surgical resection of primary tumor in the extremities improves survival for metastatic soft-tissue sarcoma patients: a population-based study of the SEER database

et al. 2021

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The Significance of Preoperative Chemotherapy in Evaluation of Recurrent Soft Tissue Liposarcoma Necrosis

Qiu¹,

Li²,

Zhang

et al. 2011

Pathol. Oncol. Res.

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To investigate the effect of preoperative induction chemotherapy on treatment of recurrent liposarcoma. 21 patients with recurrent liposarcoma received the treatment of preoperative intra-arterial chemotherapy and surgical resection. Intra-arterial chemotherapy was given by subcutaneous implantable drug delivery system with infusion of cisplatin and doxorubicin followed by caffeine. After treatment, patients were followed up for 39 months. The liposarcoma changes in CT imaging were observed in 18 cases and there were 15 cases with medium or severe pathological changes caused by chemotherapy. At the end of the postoperative follow-up of 39 months, liposarcoma reoccurred locally in 2 cases; pulmonary metastasis occurred in 1 case and death in 3 cases. Preoperative intra-arterial chemotherapy is effective for highly malignant tumors such as recurrent liposarcoma and the judgment of prognosis is based on the postoperative pathological changes of such tumor.

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Surgical outcomes for liposarcoma of the lower limbs with synchronous pulmonary metastases

Abstract: Expeditious, curative resection of both--primary and metastatic lesions--yields acceptable near-term results, with potential for long-term survival, in patients with liposarcoma of the lower limb and synchronous pulmonary metastases.

Cited by 6 publications

References 27 publications

Impact of Primary Tumor Resection on Metastasis to the Lung in Patients With Bone and Soft-tissue Sarcoma

Impact of Primary Tumor Resection on Metastasis to the Lung in Patients With Bone and Soft-tissue Sarcoma

Surgical resection of primary tumor in the extremities improves survival for metastatic soft-tissue sarcoma patients: a population-based study of the SEER database

The Significance of Preoperative Chemotherapy in Evaluation of Recurrent Soft Tissue Liposarcoma Necrosis

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