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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
"tumor grades"
symptom
dedifferentiated liposarcoma
pleomorphic liposarcoma
well-differentiated liposarcoma
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