Dedifferentiated liposarcoma in the extremity and trunk wall: A multi-institutional study of 132 cases by the Japanese Musculoskeletal Oncology Group (JMOG)

被引：5

作者：

Morii, Takeshi ^{[1
]}

Anazawa, Ukei ^{[2
]}

Sato, Chiaki ^{[3
]}

Iwata, Shintaro ^{[3
]}

Nakagawa, Makoto ^{[4
]}

Endo, Makoto ^{[4
]}

Nakamura, Tomoki ^{[5
]}

Ikuta, Kunihiro ^{[6
]}

Nishida, Yoshihiro ^{[6
]}

Nakayama, Robert ^{[7
]}

Udaka, Toru ^{[1
,7
]}

Kawamoto, Teruya ^{[8
]}

Kito, Munehisa ^{[9
]}

Sato, Kenji ^{[10
]}

Imanishi, Jungo ^{[10
]}

Akiyama, Toru ^{[11
]}

Kobayashi, Hiroshi ^{[12
]}

Nagano, Akihito ^{[13
]}

Outani, Hidetatsu ^{[14
]}

Toki, Shunichi ^{[15
]}

Nishisho, Toshihiko ^{[15
]}

Sasa, Keita ^{[16
]}

Suehara, Yoshiyuki ^{[16
]}

Kawano, Hirotaka ^{[10
]}

Ueda, Takafumi ^{[17
]}

Morioka, Hideo ^{[18
]}

机构：

[1] Kyorin Univ, Dept Orthopaed Surg, Fac Med, 6-20-2 Shinkawa, Mitaka, Tokyo 1818611, Japan

[2] Ichikawa Gen Hosp, Dept Orthopaed Surg, Tokyo Dent Coll, 5-11-13 Sugano, Ichikawa, Chiba 2728513, Japan

[3] Natl Canc Ctr, Dept Musculoskeletal Oncol & Rehabil, 5-1-1 Tsukiji, Chuo Ku, Tokyo 1040045, Japan

[4] Kyushu Univ, Dept Orthopaed Surg, Sch Med, 3-1-1 Maidashi,Hagashi Ku, Fukuoka, Fukuoka 8128582, Japan

[5] Mie Univ, Dept Orthoped Surg, Grad Sch Med, 2-174 Edobashi, Tsu, Mie 5148507, Japan

[6] Nagoya Univ, Sch Med, Dept Orthopaed Surg, Grad Sch, 65 Tsurumai,Showa Ku, Nagoya, Aichi 4668550, Japan

[7] Keio Univ, Dept Orthopaed Surg, Sch Med, 35 Shinanomachi, Tokyo, Tokyo 1608582, Japan

[8] Kobe Univ, Dept Orthopaed Surg, Grad Sch Med, 7-5-2 Kusunoki Cho,Chuo Ku, Kobe, Hyogo 6500017, Japan

[9] Shinshu Univ, Dept Orthopaed Surg, Sch Med, 3-1-1 Asahi, Matsumoto, Nagano 3908621, Japan

[10] Teikyo Univ, Dept Orthopaed Surg, Sch Med, 2-11-1 Kaga, Tokyo, Tokyo 1738606, Japan

[11] Jichi Med Univ, Saitama Med Ctr, Dept Orthopaed Surg, 1-847 Amanuma,Omiya Ku, Saitama, Saitama 3308503, Japan

[12] Univ Tokyo, Dept Orthopaed Surg, Fac Med, 7-3-1 Hongo,Bunkyo Ku, Tokyo 1130033, Japan

[13] Gifu Univ, Dept Orthopaed Surg, Grad Sch Med, 1-1 Yanagido, Gifu 5011194, Japan

[14] Osaka Univ, Dept Orthopaed Surg, Grad Sch Med, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan

[15] Tokushima Univ, Inst Biomed Sci, Dept Orthoped, Grad Sch, 3-18-15 Kuramoto, Tokushima 7708503, Japan

[16] Juntendo Univ, Dept Orthopaed Surg, Sch Med, 2-1-1 Hongo,Bunkyo Ku, Tokyo 1138421, Japan

[17] Osaka Natl Hosp, Dept Orthopaed Surg, Natl Hosp Org, 2-1-14 Houenzaka,Chuo Ku, Osaka, Osaka 5400006, Japan

[18] Tokyo Med Ctr, Dept Orthopaed Surg, Natl Hosp Org, 2-5-1, Higashigaoka,Meguro Ku, Tokyo 1528902, Japan

来源：

EJSO | 2023年 / 49卷 / 02期

关键词：

Sarcoma; Dedifferentiated liposarcoma; Extremity; Trunk wall; Prognosis; WELL-DIFFERENTIATED LIPOSARCOMA; SOFT-TISSUE; FOLLOW-UP; CLINICOPATHOLOGICAL ANALYSIS; SURGERY; TUMOR; RETROPERITONEUM; AMPLIFICATION; FEDERATION; MANAGEMENT;

D O I：

10.1016/j.ejso.2022.08.024

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Dedifferentiated liposarcoma occurs predominantly in the retroperitoneum. Given the paucity of cases, information on the clinical characteristics of this entity in the extremities and trunk wall is quite limited. In particular, the significance of preoperative evaluation and principles of intraoperative management of the different components, i.e., well-differentiated and dedifferentiated areas, are still to be defined. Methods: Clinical characteristics, treatment outcomes, and risk factors for poor oncological outcomes in cases of dedifferentiated liposarcoma in the extremity or trunk wall were analyzed by a retrospective, multicentric study. Results: A total of 132 patients were included. The mean duration from the initial presentation to dedifferentiation was 101 months in dedifferentiation-type cases. The 5-year local recurrence-free survival, metastasis-free survival, and disease-specific survival rates were 71.6%, 75.7%, and 84.7%, respectively. Among 32 patients with metastasis, 15 presented with extrapulmonary metastasis. A percentage of dedifferentiated area over 87.5%, marginal/intralesional margin, and R1/2 resection in the dedifferentiated area were independent risk factors for local recurrence. Dedifferentiated areas over 36 cm(2), French Federation of Cancer Centers Sarcoma Group grade III, and intralesional or marginal resection were independent risk factors for metastasis. A dedifferentiated area over 77 cm(2) and lung metastasis were independent risk factors for disease-specific mortality. Conclusions: The typical clinical characteristics of dedifferentiated liposarcoma in the extremity and trunk wall were reconfirmed in the largest cohort ever. The evaluation of the dedifferentiated area in terms of grade, extension, and pathological margin, together with securing adequate surgical margins, was critical in the management of this entity. (c) 2022 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

引用

页码：353 / 361

页数：9

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