BACKGROUND: There is no clear consensus as to the appropriate nomenclature and the best surgical strategy for well-differentiated liposarcomas. A wide surgical excision is recommended over marginal resection for local control of well-differentiated liposarcomas. However, this surgical procedure should be reconsidered for lesions, which come into contact with major neurovascular structures. METHODS: Between 1998 and 2004, 12 well-differentiated liposarcomas of the extremities were treated at our institute. Among them, nine lesions (75%) adjacent to major nerves or blood vessels were marginally resected with careful dissection of these critical structures. The clinical outcomes were reviewed for a mean follow-up time of 4 years. RESULTS: Seven patients continued to be disease-free without any loss of limb function. One patient developed a local recurrence 30 months postoperatively. The other patient with a foot lesion involving the fourth metatarsal bone has experienced slight difficulty in gait-balancing due to the fourth toe amputation, but remains free of disease. The local control rate was 88.9%, even though seven lesions were resected with positive surgical margins. CONCLUSIONS: Our findings suggested that well-differentiated liposarcomas frequently arise in close proximity to major nerves or blood vessels. Marginal resection alone seems to be adequate for these lesions to preserve critical structures.
BACKGROUND: There is no clear consensus as to the appropriate nomenclature and the best surgical strategy for well-differentiated liposarcomas. A wide surgical excision is recommended over marginal resection for local control of well-differentiated liposarcomas. However, this surgical procedure should be reconsidered for lesions, which come into contact with major neurovascular structures. METHODS: Between 1998 and 2004, 12 well-differentiated liposarcomas of the extremities were treated at our institute. Among them, nine lesions (75%) adjacent to major nerves or blood vessels were marginally resected with careful dissection of these critical structures. The clinical outcomes were reviewed for a mean follow-up time of 4 years. RESULTS: Seven patients continued to be disease-free without any loss of limb function. One patient developed a local recurrence 30 months postoperatively. The other patient with a foot lesion involving the fourth metatarsal bone has experienced slight difficulty in gait-balancing due to the fourth toe amputation, but remains free of disease. The local control rate was 88.9%, even though seven lesions were resected with positive surgical margins. CONCLUSIONS: Our findings suggested that well-differentiated liposarcomas frequently arise in close proximity to major nerves or blood vessels. Marginal resection alone seems to be adequate for these lesions to preserve critical structures.
Authors: Sarah B Fisher; Katherine J Baxter; Charles A Staley; Kevin E Fisher; David K Monson; Douglas R Murray; Shervin V Oskouei; Sharon W Weiss; David A Kooby; Shishir K Maithel; Keith A Delman Journal: J Am Coll Surg Date: 2013-09-25 Impact factor: 6.113
Authors: Bárbara Ortiz-Ibáñez; José V Amaya; Francisco Baixauli; Manuel Angulo; Empar Mayordomo-Aranda; Carlos Barrios Journal: World J Surg Oncol Date: 2015-06-25 Impact factor: 2.754
Authors: Jessica Rauh; Alexander Klein; Andrea Baur-Melnyk; Thomas Knösel; Lars Lindner; Falk Roeder; Volkmar Jansson; Hans Roland Dürr Journal: BMC Musculoskelet Disord Date: 2018-05-17 Impact factor: 2.362