Retroperitoneal and Intra-Abdominal Sarcoma

Liles, J. Spencer; Tzeng, Ching‐Wei D.; Short, Joshua J.; Kulesza, Peter; Heslin, Martin J.

doi:10.1067/j.cpsurg.2009.01.004

Cited by 77 publications

(112 citation statements)

References 179 publications

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“…DDLS is a heterogeneous high-grade tumor which is defined by the presence of regions of non-lipogenic sarcomatous tissue (dedifferentiated component) within a WDLS. 16 The interface between well-differentiated and dedifferentiated areas is abrupt in most DDLS cases; occasionally, these tumors exhibit a mosaic pattern. 17 If a sample is obtained only from the well-differentiated component of the tumor, then the pathologic finding will be WDLS.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes

et al. 2014

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Background 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. Methods 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. Results 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 % (86/137); the accuracy for identifying WDLS was significantly higher (85.1 %; 63/74) than that for identifying DDLS (36.5 %; 23/63) (p < 0.01). Conclusions 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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Section: Discussionmentioning

confidence: 99%

Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes

et al. 2014

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“…Retroperitoneal liposarcomas tend to be of low to intermediate grade, while other sarcomas of other histologic types e.g. leiomyosarcomas in this location tend to be high grade[4,15,16]. Sarcomas are believed to arise de novo , spreading by direct, local extension or hematogenous routes, metastases at the time of initial presentation are uncommon.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal liposarcomas: the experience of a tertiary Asian center

et al. 2011

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BackgroundLiposarcoma is the single most common soft tissue sarcoma in the retroperitoneum.Materials and methodsA retrospective review of patients with primary retroperitoneal liposarcoma treated between June 1990 and June 2005 were conducted to evaluate the clinical results of resection for retroperitoneal liposarcomas (RPLS) and the prognostic factors for disease recurrence and patient survival in an Asian population.ResultsTwenty-one patients operated on for curative intent (12 Males, 9 Females; mean age: 52.4 years) were evaluated. Of these, 13 presented with tumors that were well differentiated (61.9%), 4 (19.0%) with myxoid/round cell, 3 (14.3%) with dedifferentiated and 1(4.8%) with pleomorphic morphology. The median tumor burden was 36 cm (9-83). Median follow-up time was 62 months. There was no peri-operative mortality and morbidity occurred in 6(28.6%) patients. Surgical margins were involved in 10(47.6%) patients. Resection of contiguous organs was required in 15(71.4%) to achieve gross surgical margins. Eleven out of the 21(52%) of the patients had recurrence of the tumor. Median disease-free survival was 19 months and the overall 3- and 5-year survival rate was 87% and 49% respectively.ConclusionAn aggressive surgical approach in both primary and recurrent RPLS in our institution is associated with 3- and 5-year survival rate of 87% and 49% respectively. Contiguous organ resection is often required to achieve local control.

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“…Based on all the examinations performed, a sarcoma was the most likely origin. The first step in therapy was cytoreduction because surgical resection is the treatment of choice for sarcoma [31, 32] and investigations revealed this was feasible. With the HIPEC containing cisplatin and doxorubicin as intraperitoneal components, we applied a chemotherapy regimen with cytotoxic effect against a wide variety of malignancies.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Peritoneal Carcinomatosis

Hillewaere¹,

Stessens

Speeten³

2010

Case Rep Oncol

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The peritoneal surface remains an important failure site for patients with gastrointestinal and gynecologic malignancies. In the past, oncologists regarded peritoneal carcinomatosis as an incurable component of an intra-abdominal malignancy. During the last two decades, novel therapeutic approaches have emerged for peritoneal carcinomatosis patients. We report the first case of peritoneal carcinomatosis emerging from an extra-adrenal, intra-abdominal paraganglioma. This 49-year-old male was treated with cytoreductive surgery and hyperthermic intraperitoneal perioperative chemotherapy. Paragangliomas are rare tumors of neural crest-derived chromaffin cells and can originate either from the sympathetic or from the parasympathetic ganglia. It has been estimated that as many as 10% of the paragangliomas arise outside the adrenal glands. This case represents an unreported presentation of paraganglioma. Two possible origins of this malignancy, and the applied therapy, are discussed. We report the feasibility of cytoreductive surgery plus hyperthermic intraperitoneal perioperative chemotherapy in the treatment of this malignancy.

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Retroperitoneal and Intra-Abdominal Sarcoma

Cited by 77 publications

References 179 publications

Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes

Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes

Retroperitoneal liposarcomas: the experience of a tertiary Asian center

An Unusual Case of Peritoneal Carcinomatosis

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