Surgical management of truncal and extremities atypical lipomatous tumors/well-differentiated liposarcoma: A systematic review of the literature

Choi, Kyoo-Yoon; Jost, Evan; Mack, Lloyd A.; Bouchard‐Fortier, Antoine

doi:10.1016/j.amjsurg.2020.01.046

Cited by 36 publications

(22 citation statements)

References 16 publications

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“…For inclusion in this study, the patients were also required to have tumors with definitive immunohistochemistry or cytogenetic confirmation of MDM2 amplification to rule out lipomas for WD disease and other sarcoma subtypes for DD disease (e.g., pleomorphic liposarcoma and undifferentiated pleomorphic sarcoma). In a recent literature review, only 16.8% of patients (133 out of 793 in total) had this level of diagnostic accuracy 7 . In our opinion, this is critical and may explain the discrepancy in the frequency of DD noted in our study (27.6%) versus 1%–2% in the reported literature in which the denominator may have erroneously included large or atypical lipomas 5–7 …”

Section: Discussioncontrasting

confidence: 54%

“…In two recent, independent single‐institution studies focused on this body location, DD disease was observed in only 1%–2% of patients 5,6 . Consistent with this, in a large systemic review of the literature which included data extracted from 18 studies, DD was confirmed in only 9 of 793 (1.1%) of patients 7 . Due to the reported rarity of DD and overall better outcome of these low‐grade tumors, the term “atypical lipomatous tumor” has been suggested as an alternative name for WD liposarcoma of the extremity/trunk.…”

Section: Introductionmentioning

confidence: 54%

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Dedifferentiation within well‐differentiated liposarcoma of the extremity or trunk: Implications for clinical management

Tseng

Barretta

Baia

et al. 2021

Journal of Surgical Oncology

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Background In extremity or trunk liposarcoma, the implications of a dedifferentiated (DD) component within a well‐differentiated (WD) tumor are unclear. We evaluated outcomes after surgery and identified potential predictors of survival in these patients compared to those with an entirely WD tumor. Methods Retrospective data were collected for patients who underwent complete resection from 2009 to 2019. Cumulative incidences of local recurrence (LR) and distant metastasis (DM) were calculated, and overall survival (OS) was estimated. Associations between OS and clinicopathologic variables were evaluated by univariable models. Results A total of 210 patients with MDM2‐verified tumors were studied, including 58 (27.6%) with DD. In primary disease, LR occurred only in DD and worse OS was observed versus WD (p < 0.001). In recurrent disease, the LR incidences were similar between WD and DD (p = 0.559); however, worse OS persisted in DD (p = 0.004). The incidence of DM was extremely low (3.8%) and limited to DD. Higher grade (p < 0.001) and DD size (p = 0.043), but not overall tumor size were associated with worse OS. Conclusions In extremity or trunk liposarcoma, the presence of DD leads to significantly worse outcomes in both primary and recurrence diseases. Further study is needed to determine if these patients benefit from adjunct therapies (e.g., radiation).

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Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 54%

Dedifferentiation within well‐differentiated liposarcoma of the extremity or trunk: Implications for clinical management

Tseng

Barretta

Baia

et al. 2021

Journal of Surgical Oncology

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“…It is widely accepted that retroperitoneal WDL/DDL and extremity ALT/DDL differ clinically in regard to recurrence rates, dedifferentiation and survival. Extremity liposarcomas have a lower local recurrence rate, dedifferentiate less frequently and have an improved disease specific survival compared to their retroperitoneal counterparts [60,61]. The superior outcomes of extremity liposarcoma are likely due in part to anatomical location, the suitability for radiotherapy and the fact that clear surgical margins are easier to achieve.…”

Section: Comparison Of Genomic Aberrations Between Retroperitoneal Anmentioning

confidence: 99%

A review of retroperitoneal liposarcoma genomics

Tyler

Wanigasooriya

Tanière

et al. 2020

Cancer Treatment Reviews

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Retroperitoneal liposarcomas are rare tumours that carry a poorer prognosis than their extremity counterparts. Within their subtypes-well differentiated (WDL), dedifferentiated (DDL), myxoid (MLS) and pleomorphic (PLS)-they exhibit a diverse genomic landscape. With recent advances in next generation sequencing, the number of studies exploring this have greatly increased. The recent literature has deepened our understanding of the hallmark MDM2/CDK4 amplification in WDL/DDL and addressed concerns about toxicity and resistance when targeting this. The FUS-DDIT3 fusion gene remains the primary focus of interest in MLS with additional potential targets described. Whole genome sequencing has driven identification of novel genes and pathways implicated in WDL/DDL outside of the classic 12q13-15 amplicon. Due to their rarity; anatomical location and histologic subtype are infrequently mentioned when reporting the results of these studies. Reports can include non-adipogenic or extremity tumours, making it difficult to draw specific retroperitoneal conclusions. This narrative review aims to provide a summary of retroperitoneal liposarcoma genomics and the implications for therapeutic targeting. summary of specific retroperitoneal liposarcoma genomics is lacking in the literature. This would be useful to clinicians and scientists alike, dealing with this specific disease in the era of personalised medicine. Secondly, it is well established that variations in the tumour microenvironment can determine response to therapy. Lastly, RPL carries a poorer prognosis than extremity LS, has a distinct natural history and is managed differently. Methods Search strategy A literature search was conducted using the Embase, MEDLINE, PubMed and Cochrane Library databases. The following keywords were used to perform flexible searches within these databases: 'Retroperitoneal' AND 'sarcoma', 'liposarcoma', 'genomics', 'genetics', 'mutation', and 'genomic therapy.' Only papers published in English were included.

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“…46,47 The probability of an ALT developing a dedifferentiated component is very low, close to 1%, and this is usually observed only after tumor recurrence. 48…”

Section: Watchful Waitingmentioning

confidence: 99%

“…The probability of an ALT developing a dedifferentiated component is very low, close to 1%, and this is usually observed only after tumor recurrence 48 . About 5% of DFSP harbor a fibrosarcomatous component that is more aggressive and is associated with a faster growth rate and a metastatic risk that is in the 15% range 46,49,50 .…”

Section: Sts Of the Extremity And Trunkmentioning

confidence: 99%

Strategies for care of patients with gastrointestinal stromal tumor or soft tissue sarcoma during COVID‐19 pandemic: A guide for surgical oncologists

Callegaro

Raut

Keung

et al. 2020

Journal of Surgical Oncology

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The coronavirus disease‐2019 (COVID‐19) pandemic is deeply impacting the accessibility of cancer patients to surgery. In resource‐limited conditions, the standard of care might not be deliverable, but evidence to support alternative management strategies often exists. By revisiting available treatment options, this review provides surgical oncologists with an evidence‐based framework for treating patients with gastrointestinal stromal tumor, extremity/truncal soft tissue sarcoma, and retroperitoneal sarcoma to rapidly adapt their decision‐making to the constant evolution of the COVID‐19 pandemic.

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Surgical management of truncal and extremities atypical lipomatous tumors/well-differentiated liposarcoma: A systematic review of the literature

Cited by 36 publications

References 16 publications

Dedifferentiation within well‐differentiated liposarcoma of the extremity or trunk: Implications for clinical management

Dedifferentiation within well‐differentiated liposarcoma of the extremity or trunk: Implications for clinical management

A review of retroperitoneal liposarcoma genomics

Strategies for care of patients with gastrointestinal stromal tumor or soft tissue sarcoma during COVID‐19 pandemic: A guide for surgical oncologists

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