ObjectiveThis study intended to retrospectively analyze the data of patients with primary retroperitoneal liposarcoma in a single Asian large-volume sarcoma center and to establish nomograms focused on PRLPS for predicting progression-free survival (PFS) and overall survival (OS).MethodsA total of 211 patients treated surgically for primary, non-metastatic retroperitoneal liposarcoma during 2009–2021 were identified, and clinicopathologic variables were analyzed. PFS and OS nomograms were built based on variables selected by multivariable analysis. The discriminative and predictive ability of the nomogram was assessed by concordance index and calibration curve.ResultsThe median follow-up time was 25 months. A total of 117 (56%) were well-differentiated, 78 (37%) were dedifferentiated, 13 (6%) were myxoid, and 3 (1%) were pleomorphic morphology. Compared to the western population cohort reported by the Memorial Sloan-Kettering Cancer Center, the median age of patients in this cohort was younger (57 vs. 63 years), the tumor burden was lower (20 vs. 26 cm), and the proportion of patients with R0 or R1 resection was higher (97% vs. 81%). The 5-year PFS rate was 49%, and factors independently associated with PFS were symptoms at visit, preoperative needle biopsy, histologic subtypes, and postoperative hospital stay. The 5-year OS rate was 72%. American Society of Anesthesiologists Physical Status and Clavien-Dindo classification were independently associated with OS. The concordance indexes for PFS and OS nomograms were 0.702 and 0.757, respectively. The calibration plots were excellent.ConclusionsThe proposed nomogram provided a favorable reference for the treatment of primary retroperitoneal liposarcoma patients.

Background and Objectives: Surgical treatment is still the mainstay of curative therapy for retroperitoneal liposarcoma (RLPS), but often recurs after surgical resection. We aimed to establish a nomogram for postoperative recurrence of RLPS based on the Asian population. Methods: Patients after surgical resection at the South Hospital of Zhongshan Hospital/ Shanghai Public Health Clinical Center between August 2011 and December 2020 were included. The enrolled patients are randomly divided into training set and test set according to the ratio of 7:3. Prognostic factors were chosen based on Akaike Information Criterion, and the nomogram was built based on Cox regression and then internally validated through calibration plots and concordance index (C-index). Results: A total of 447 patients were included. Gender, age, presentation status, organ invasion and FNCLCC grade were used to build nomogram. The calibration plots showed that RFS predicted probabilities are identical to the actual RFS rates. The C-index of the nomogram was 0.703 (95% CI 0.623-0.783) in the training set and 0.695 (95% CI 0.565-0.825) in test set. Conclusion:The nomogram we established can accurately predict postoperative recurrence of RLPS patients for Asian population.

Our previous study has indicated that cancer-associated fibroblasts (CAFs) play a crucial role in regulating gemcitabine resistance through transferring exosomal miRNA-106b to cancer cells. Tumor-associated macrophages (TAMs) are recently verified to facilitate gemcitabine resistance. However, the effect of CAFs in regulating TAMs function in pancreatic cancer (PCa) remains unclear. Here, primary CAFs were extracted from tumor tissues of PCa patients, and CAFs-derived exosomes (CAFs-Exo) were acquired and authenticated by transmission electron microscopy, qNano, and western blot analysis. The role of exosomal miRNA-320a in facilitating macrophage M2 polarization was investigated in vitro. We found that CAFs-derived conditioned medium (CM) possessed a higher potential to promote macrophage M2 polarization compared with normal fibroblasts (NFs) or PCa cell-derived CM. Furthermore, CAFs-Exo treatment polarized macrophage to M2 phenotype. miRNA-320a levels were remarkably increased in CAFs-Exo versus NFs-Exo. More important, miRNA-320a could be transferred from CAFs to macrophages through exosomes, and miRNA-320a overexpression in macrophages facilitated its M2 polarization. Functionally, miRNA-320a-overexpressed macrophages facilitated PCa cell proliferation and invasion. CAFs pretreated with miRNA-320a inhibitor reduced miRNA-320a expression in CAFs-Exo and led to decreased M2 macrophage polarization. Finally, we verified that miRNA-320a polarized macrophage to M2 phenotype by regulating PTEN/PI3Kγ signaling. Taken together, the current data demonstrated that CAFs-derived exosomal miRNA-320a facilitated macrophage M2 polarization to accelerate malignant behavior of PCa cells.