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Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes.
[liposarcoma]
Surgery
is
the
primary
treatment
for
all
subtypes
of
retroperitoneal
liposarcoma
,
but
neoadjuvant
therapy
may
be
warranted
in
cases
of
dedifferentiated
liposarcoma
(
DDLS
)
,
which
has
an
increased
risk
of
recurrence
and
metastasis
.
Therefore
,
an
accurate
subtype-
specific
diagnosis
is
vital
for
appropriate
consideration
of
neoadjuvant
therapy
.
Previous
studies
assessing
the
subtype-
specific
accuracy
of
percutaneous
biopsy
are
limited
.
We
aimed
to
analyze
the
accuracy
of
preoperative
percutaneous
biopsy
in
the
subtype-
specific
diagnosis
of
retroperitoneal
liposarcoma
and
thus
the
reliability
of
percutaneous
biopsy
in
guiding
decisions
about
neoadjuvant
treatment
.
We
retrospectively
reviewed
the
medical
records
,
including
the
pathologic
reports
,
interventional
radiology
reports
,
and
operative
reports
,
of
patients
registered
in
the
retroperitoneal
/
well-differentiated
liposarcoma
(
WDLS
/
DDLS
)
database
at
The
University
of
Texas
MD
Anderson
Cancer
Center
between
1993
and
2013
.
We
identified
120
patients
who
underwent
137
preoperative
percutaneous
biopsies
followed
by
surgical
resections
.
Pathologic
examination
following
resection
indicated
that
74
of
the
patients
had
WDLS
and
63
had
DDLS
.
The
overall
diagnostic
accuracy
of
percutaneous
biopsy
for
identifying
the
subtype
of
liposarcoma
was
62
.
8
Â
%
(
86
/
137
)
;
the
accuracy
for
identifying
WDLS
was
significantly
higher
(
85
.
1
Â
%
;
63
/
74
)
than
that
for
identifying
DDLS
(
36
.
5
Â
%
;
23
/
63
)
(
p
Â
<
Â
0
.
01
)
.
Percutaneous
biopsy
has
low
accuracy
in
the
diagnosis
of
retroperitoneal
DDLS
.
This
can
potentially
mislead
physicians
in
the
decision
to
implement
neoadjuvant
treatment
.
When
developing
treatment
strategies
,
including
clinical
trials
for
patients
with
retroperitoneal
liposarcoma
,
physicians
should
carefully
consider
the
low
accuracy
of
percutaneous
biopsy
in
detecting
DDLS
.
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"thus the reliability of percutaneous biopsy in guiding decisions about neoadjuvant treatment"
symptom
liposarcoma
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