Predictors of outcomes in patients with primary retroperitoneal dedifferentiated liposarcoma undergoing surgery.

[dedifferentiated liposarcoma]

Although sarcoma histology is recognized as a prognostic factor , most studies of retroperitoneal sarcomas report results combining multiple histologies and are inadequately powered to identify prognostic factors specific to a particular histology . We reviewed our experience with retroperitoneal dedifferentiated liposarcoma (RP DDLPS ) to identify factors predictive of outcomes .All patients with RP DDLPS treated at our institution between 1998 and 2008 were reviewed . Multivariable Cox regression analyses were performed to identify factors predictive of progression-free survival (PFS ), local recurrence-free survival (LRFS ), distant recurrence-free survival (DRFS ), and overall survival (OS ).We identified 119 patients with primary DDLPS . Median tumor size was 20 .5 cm ; 21 % were multifocal . French Federation of Cancer Centers Sarcoma Group tumor grades were intermediate in 53 % of patients and high in 28 % (unknown 19 %). Resections were complete (R 0 /R 1 ) in 80 % of patients and incomplete (R 2 ) in 11 % (unknown 9 %). Tumors were removed intact in 72 % of patients and fragmented in 16 % (unknown 12 %). Median follow-up was 74 .1 months . One hundred patients (84 %) experienced recurrence or progression , with 92 % occurring in the retroperitoneum . Median PFS , LRFS , DRFS , and OS were 21 .1 , 21 .5 , 45 .8 , and 59 .0 months , respectively , and were significantly worse with R 2 resection . On multivariate analysis , tumor integrity (intact vs fragmented ) was predictive of PFS , multifocality predicted LRFS , and extent of resection (R 0 /R 1 vs R 2 ), grade , and tumor integrity predicted OS .In this cohort of primary RP DDLPS , factors under surgeon control (tumor integrity , extent of resection ) and reflective of tumor biology (grade , multifocality ) impact patient outcomes .

Diseases
Validation

Diseases presenting "distant recurrence-free survival" symptom

dedifferentiated liposarcoma

well-differentiated liposarcoma

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