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Personalizing the Approach to Retroperitoneal Soft Tissue Sarcoma: Histology-specific Patterns of Failure and Postrelapse Outcome after Primary Extended Resection.
[dedifferentiated liposarcoma]
To
explore
patterns
of
failure
and
postrelapse
outcome
of
patients
with
retroperitoneal
sarcoma
primarily
treated
by
extended
resection
.
All
consecutive
patients
with
primary
retroperitoneal
sarcoma
,
treated
between
January
2002
and
December
2011
at
two
European
sarcoma
centers
were
included
.
Five
-
year
overall
survival
(
OS
)
and
crude
cumulative
incidence
(
CCI
)
of
local
recurrence
(
LR
)
and
distant
metastases
(
DM
)
were
calculated
.
Multivariate
analyses
for
OS
and
CCI
of
LR
and
DM
were
performed
.
Postrelapse
OS
was
investigated
.
A
total
of
377
patients
were
identified
.
Median
follow-up
from
the
time
of
primary
surgery
was
44
Â
months
[
interquartile
range
(
IQR
)
27
-
82
]
.
Five
-
year
OS
was
64
Â
%
[
95
Â
%
confidence
interval
(
CI
)
0
.
588
,
0710
]
.
CCI
of
LR
and
DM
were
23
.
6
Â
%
(
95
Â
%
CI
18
.
9
,
29
.
4
)
and
21
.
9
Â
%
(
95
Â
%
CI
17
.
6
,
27
.
3
)
,
respectively
.
OS
,
CCI
of
LR
and
DM
were
87
,
18
Â
%
and
0
for
well-differentiated
liposarcoma
;
54
,
44
and
9
Â
%
for
grade
II
dedifferentiated
liposarcoma
;
41
,
33
,
and
44
Â
%
for
grade
III
dedifferentiated
liposarcoma
;
58
,
5
,
and
55
Â
%
for
leiomyosarcoma
;
and
85
,
4
,
and
17
Â
%
for
solitary
fibrous
tumor
,
respectively
.
Seventy
-
six
patients
developed
LR
.
Median
postrelapse
follow-up
was
27
Â
months
(
IQR
10
-
58
)
.
Twenty
-
one
patients
(
27
Â
%
)
underwent
a
second
surgical
resection
(
complete
in
18
)
,
while
55
(
73
Â
%
)
did
not
(
22
multifocal
,
17
inoperable
,
16
other
causes
)
.
Median
postrelapse
OS
was
17
Â
months
(
IQR
7
-
31
)
.
Well-differentiated
liposarcoma
histology
and
disease-free
interval
predicted
postrelapse
OS
,
while
surgical
resection
did
not
.
When
primary
extended
surgery
limits
LR
,
histologic
subtype
and
grade
determine
the
outcome
.
At
recurrence
,
a
second
surgery
is
of
limited
benefit
.
Diseases
Validation
Diseases presenting
"respectively"
symptom
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
alpha-thalassemia
benign recurrent intrahepatic cholestasis
carcinoma of the gallbladder
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dentinogenesis imperfecta
epidermolysis bullosa simplex
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
harlequin ichthyosis
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
kallmann syndrome
lamellar ichthyosis
liposarcoma
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyruvate dehydrogenase deficiency
scrub typhus
triple a syndrome
von hippel-lindau disease
well-differentiated liposarcoma
wolf-hirschhorn syndrome
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