Carolyn Nessim1, Chandrajit P Raut2, Dario Callegaro3, Francesco Barretta4, Rosalba Miceli4, Mark Fairweather2, Jean-Yves Blay5, Dirk Strauss6, Piotr Rutkowski7, Nita Ahuja8,9, Ricardo Gonzalez10, Giovanni Grignani11, Vittorio Quagliuolo12, Eberhard Stoeckle13, Guy Lahat14, Antonino De Paoli15, Venu G Pillarisetty16, Robert J Canter17, John T Mullen18, Elisabetta Pennacchioli19, Winan van Houdt20, Carol J Swallow21, Yvonne Schrage20,21,22, Kenneth Cardona23, Marco Fiore3, Alessandro Gronchi3, Sanjay P Bagaria24. 1. Department of Surgery, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada. cnessim@toh.ca. 2. Department of Surgery, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA, USA. 3. Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 4. Department of Applied Research and Technological Development, Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 5. Department of Medical Oncology, Center Léon Bérard Cancer Center, Lyon, France. 6. Department of Surgery, Royal Marsden Hospital NHS Foundation Trust, London, UK. 7. Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland. 8. Department of Surgery, Yale School of Medicine, New Haven, CT, USA. 9. John Hopkins University School of Medicine, Baltimore, MD, USA. 10. Department of Surgery, Moffitt Cancer Center, Tampa, FL, USA. 11. Division of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy. 12. Department of Surgery, Istituto Clinico Humanitas IRCCS, Milan, Italy. 13. Department of Surgery, Institut Bergonié, Bordeaux, France. 14. Department of Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. 15. Department of Radiation Oncology, Centro di Riferimento Oncologico, Aviano, Italy. 16. Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA. 17. Department of Surgery, UC Davis Health, Sacramento, CA, USA. 18. Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. 19. Division of Melanoma, Sarcomas and Rare Tumors, IEO, European Institute of Oncology, IRCCS, Milan, Italy. 20. Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands. 21. Department of Surgery, Mount Sinai Hospital and Princess Margaret Cancer Center, Toronto, Canada. 22. Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands. 23. Department of Surgery, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA. 24. Department of Surgery, Mayo Clinic, Jacksonville, FL, USA.
Abstract
BACKGROUND: Local recurrence following resection of retroperitoneal liposarcoma (RLPS) is common. Well-differentiated (WD) and dedifferentiated (DD) RLPS are distinct entities with differing outcomes. A few reports suggest that WDLPS can recur as DDLPS and that DDLPS can recur as WDLPS. This study evaluates whether this change in differentiation from the primary tumor to the first local recurrence impacts long-term outcomes. METHODS: Retrospective review from 22 sarcoma centers identified consecutive patients who underwent resection for a first locally recurrent RLPS from January 2002 to December 2011. Outcomes measured included overall survival, local recurrence, and distant metastasis. RESULTS: A total of 421 RPLS patients were identified. Of the 230 patients with primary DDLPS, 34 (15%) presented WDLPS upon recurrence (DD → WD); and of the 191 patients with primary WDLPS, 54 (28%) presented DDLPS upon recurrence (WD → DD). The 6-year overall survival probabilities (95% CI) for DD → DD, DD → WD, WD → WD, and WD → DD were 40% (32-48%), 73% (58-92%), 76% (68-85%), and 56% (43-73%) (p < 0.001), respectively. The 6-year second local recurrence incidence was 66% (59-73%), 63% (48-82%), 66% (57-76%), and 77% (66-90%), respectively. The 6-year distant metastasis incidence was 13% (9-19%), 3% (0.4-22%), 5% (2-11%), and 4% (1-16%), respectively. On multivariable analysis, DD → WD was associated with improved overall survival when compared with DD → DD (p < 0.001). Moreover, WD → DD was associated with a higher risk of LR (p = 0.025) CONCLUSION: A change in RLPS differentiation from primary tumor to first local recurrence appears to impact survival. These findings may be useful in counseling patients on their prognosis and subsequent management.
BACKGROUND: Local recurrence following resection of retroperitoneal liposarcoma (RLPS) is common. Well-differentiated (WD) and dedifferentiated (DD) RLPS are distinct entities with differing outcomes. A few reports suggest that WDLPS can recur as DDLPS and that DDLPS can recur as WDLPS. This study evaluates whether this change in differentiation from the primary tumor to the first local recurrence impacts long-term outcomes. METHODS: Retrospective review from 22 sarcoma centers identified consecutive patients who underwent resection for a first locally recurrent RLPS from January 2002 to December 2011. Outcomes measured included overall survival, local recurrence, and distant metastasis. RESULTS: A total of 421 RPLS patients were identified. Of the 230 patients with primary DDLPS, 34 (15%) presented WDLPS upon recurrence (DD → WD); and of the 191 patients with primary WDLPS, 54 (28%) presented DDLPS upon recurrence (WD → DD). The 6-year overall survival probabilities (95% CI) for DD → DD, DD → WD, WD → WD, and WD → DD were 40% (32-48%), 73% (58-92%), 76% (68-85%), and 56% (43-73%) (p < 0.001), respectively. The 6-year second local recurrence incidence was 66% (59-73%), 63% (48-82%), 66% (57-76%), and 77% (66-90%), respectively. The 6-year distant metastasis incidence was 13% (9-19%), 3% (0.4-22%), 5% (2-11%), and 4% (1-16%), respectively. On multivariable analysis, DD → WD was associated with improved overall survival when compared with DD → DD (p < 0.001). Moreover, WD → DD was associated with a higher risk of LR (p = 0.025) CONCLUSION: A change in RLPS differentiation from primary tumor to first local recurrence appears to impact survival. These findings may be useful in counseling patients on their prognosis and subsequent management.
Authors: Anthony M Villano; Roberto J Vidri; Elaine T Vo; Stephanie H Greco; Krisha J Howell; Margaret von Mehren; Jeffrey M Farma Journal: Ann Surg Oncol Date: 2021-10-11 Impact factor: 5.344
Authors: William W Tseng; Carol J Swallow; Dirk C Strauss; Sylvie Bonvalot; Piotr Rutkowski; Samuel J Ford; Ricardo J Gonzalez; Rebecca A Gladdy; David E Gyorki; Mark Fairweather; Kyo Won Lee; Markus Albertsmeier; Winan J van Houdt; Magalie Fau; Carolyn Nessim; Giovanni Grignani; Kenneth Cardona; Vittorio Quagliuolo; Valerie Grignol; Jeffrey M Farma; Elisabetta Pennacchioli; Marco Fiore; Andrew Hayes; Dimitri Tzanis; Jacek Skoczylas; Max L Almond; John E Mullinax; Wendy Johnston; Hayden Snow; Rick L Haas; Dario Callegaro; Myles J Smith; Toufik Bouhadiba; Anant Desai; Rachel Voss; Roberta Sanfilippo; Robin L Jones; Elizabeth H Baldini; Andrew J Wagner; Charles N Catton; Silvia Stacchiotti; Khin Thway; Christina L Roland; Chandrajit P Raut; Alessandro Gronchi Journal: Ann Surg Oncol Date: 2022-06-29 Impact factor: 4.339