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Dedifferentiation within well‐differentiated liposarcoma of the extremity or trunk: Implications for clinical management
Author(s) -
Tseng William W.,
Barretta Francesco,
Baia Marco,
Barisella Marta,
Radaelli Stefano,
Callegaro Dario,
Yoon Dong Hum,
Fiore Marco,
Gronchi Alessandro
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26590
Subject(s) - medicine , liposarcoma , trunk , incidence (geometry) , retrospective cohort study , overall survival , cumulative incidence , radiation therapy , gastroenterology , surgery , distant metastasis , metastasis , oncology , sarcoma , pathology , cancer , cohort , ecology , physics , optics , biology
Background In extremity or trunk liposarcoma, the implications of a dedifferentiated (DD) component within a well‐differentiated (WD) tumor are unclear. We evaluated outcomes after surgery and identified potential predictors of survival in these patients compared to those with an entirely WD tumor. Methods Retrospective data were collected for patients who underwent complete resection from 2009 to 2019. Cumulative incidences of local recurrence (LR) and distant metastasis (DM) were calculated, and overall survival (OS) was estimated. Associations between OS and clinicopathologic variables were evaluated by univariable models. Results A total of 210 patients with MDM2‐verified tumors were studied, including 58 (27.6%) with DD. In primary disease, LR occurred only in DD and worse OS was observed versus WD ( p < 0.001). In recurrent disease, the LR incidences were similar between WD and DD ( p = 0.559); however, worse OS persisted in DD ( p = 0.004). The incidence of DM was extremely low (3.8%) and limited to DD. Higher grade ( p < 0.001) and DD size ( p = 0.043), but not overall tumor size were associated with worse OS. Conclusions In extremity or trunk liposarcoma, the presence of DD leads to significantly worse outcomes in both primary and recurrence diseases. Further study is needed to determine if these patients benefit from adjunct therapies (e.g., radiation).