The importance of the margin of resection and radiotherapy in retroperitoneal liposarcoma

Littau, Michael; Kulshrestha, Sujay; Bunn, Corinne; Agnew, Sonya P.; Sweigert, Patrick J.; Luchette, Fred A.; Baker, Marshall S.

doi:10.1016/j.amjsurg.2020.11.041

Cited by 15 publications

(11 citation statements)

References 10 publications

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“…However, subgroup analysis showed bene t in liposarcoma (44). Retrospective analysis of the NCDB pointed to a survival advantage in non-lipomatous RPS that had received radiotherapy (32). In retrospective studies, selection bias may explain the association with better survival, and causal inference cannot be made.…”

Section: Discussionmentioning

confidence: 99%

Extended surgical resection for primary retroperitoneal sarcoma. Systematic review and meta- analysis

Hussein

Shoman

Elbalka

2022

Preprint

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Background & Objectives: Retroperitoneal sarcomas are often advanced at presentation. Surgery remains the only available curative management. The extent of surgical resection is debatable. There is a strong cause for compartmental resection of the whole hemi-retroperitoneum, but high-level evidence is lacking. This systematic review examines published evidence for the effect of resection policy on the oncologic outcome.Methods: The PubMed was searched for “retroperitoneal neoplasms”, “surgery”, “surgical procedures, operative”, and “margin of resection”. Web Of Science™ was searched for “retroperitoneal neoplasms” and “surgical management”. English-language articles that investigated retroperitoneal sarcoma in adult patients with extent of surgery as an independent variable and oncologic outcome as endpoints were included.Results: Twenty-three articles were retained for analysis. All articles were retrospective. Meta-analysis showed equivalence of overall survival with extended surgery versus limited surgery and with sole tumor resection versus en-bloc resection with contiguous organs. Multivisceral resection did not increase morbidity. Conclusions: The role of universal extended surgery and the subset of patients who may benefit from irradiation treatment remain open questions.

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Section: Discussionmentioning

confidence: 99%

Extended surgical resection for primary retroperitoneal sarcoma. Systematic review and meta- analysis

Hussein

Shoman

Elbalka

2022

Preprint

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“…In this analyse, the prognosis of different histological subtypes varied greatly, and well‐differentiated RPLS had a significantly prolonged LRFS than de‐differentiated and other subtypes. In addition, well‐differentiated RPLS often has an intact tumor capsule and regular shape, which enables the boundary between the tumor and normal tissue to be easily identified, thus shortening operation time, reducing intraoperative bleeding, and facilitating the completion of radical resection [11, 29, 30]. Tumor grade, that is, the degree of malignancy, is closely related to the recurrence, metastasis, and prognosis of the tumor.…”

Section: Discussionmentioning

confidence: 99%

Correlation Analysis Between Demographic, Surgical, and Pathological Characteristics with Local Recurrence‐Free Survival for Surgical Resected Retroperitoneal Liposarcoma

Zhao

Gao

et al. 2023

World j. surg.

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Background As the leading cause of mortality for retroperitoneal liposarcoma (RPLS) cases, postoperative recurrence has complicated and unclear risk factors. This study was conducted to explore the correlations between demographic, surgical, and pathological characteristics with local recurrence-free survival (LRFS) for surgical resected RPLS. Methods RPLS cases that underwent radical operation were considered to be included in this analysis. LRFS rates were estimated based on the Kaplan-Meier method and were compared between groups by the log-rank test. Cox proportional hazard regression models were constructed to identified the predictors of LRFS. Subsequently, the independent predictors acquired from multivariate analyses were used to construct a nomogram. Results 348 RPLS cases who underwent radical operation were included. Of the 348 cases, 333 had tumor recurrence or with a follow-up period C5 years. Thus, 296 (88.9%) of the 333 cases had recurrent disease, and the median LRFS duration of 296 recurrence cases was 17.0 (95% confidence interval (CI) 13.2-20.8) months. Multivariate analysis identified the preoperative neutrophil/lymphocyte ratio (NLR), surgical frequency, operative time, tumor shape, histological subtype, and tumor necrosis as independent predictors of LRFS. Based on above independent predictors, a nomogram was constructed to predict the 1-, 3-, and 5-year LRFS of surgical resected RPLS. Conclusion Elevated preoperative NLR, C2nd time surgical frequency, extended operation time, irregular tumor shape, no well-differentiated histological subtype, and tumor necrosis could be used as predictors of LRFS for surgical resected RPLS.

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“…Notably, in a subgroup analysis within the STRASS-1 trial, neoadjuvant radiation seemed to improve outcomes in patients with low-grade WDLPS but was not recommended in those with high-grade RPS [ 107 ]. A subsequent retrospective review of the National Cancer Database revealed a survival benefit only in those with high-grade liposarcoma measuring greater than 10 cm receiving radiation in the adjuvant setting [ 109 ]. Additional details regarding dosing, target volumes, techniques, and the overall role of RT in RPS management are outlined in a 2021 review [ 110 ], and summarized within the 2021 American Society of Radiation Oncology clinical practice guidelines for soft-tissue sarcoma [ 111 ].…”

Section: Radiation Therapymentioning

confidence: 99%

Retroperitoneal Sarcoma Care in 2021

Schmitz

Nessim

2022

Cancers

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Soft-tissue sarcomas are biologically heterogenous tumors arising from connective tissues with over 100 subtypes. Although sarcomas account for <1% of all adult malignancies, retroperitoneal sarcomas are a distinct subgroup accounting for <10% of all sarcomatous tumors. There have been considerable advancements in the understanding and treatment of retroperitoneal sarcoma in the last decade, with standard treatment consisting of upfront primary surgical resection. The evidence surrounding the addition of radiation therapy remains controversial. There remains no standard with regards to systemic therapy, including immunotherapy. Adjunctive therapy remains largely dictated by expert consensus and preferences at individual centers or participation in clinical trials. In this 2021 review, we detail the anatomical boundaries of the retroperitoneum, clinical characteristics, contemporary standard of care and well as recent advancements in retroperitoneal sarcoma care. Ongoing international collaborations are encouraged to advance our understanding of this complex disease.

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The importance of the margin of resection and radiotherapy in retroperitoneal liposarcoma

Cited by 15 publications

References 10 publications

Extended surgical resection for primary retroperitoneal sarcoma. Systematic review and meta- analysis

Extended surgical resection for primary retroperitoneal sarcoma. Systematic review and meta- analysis

Correlation Analysis Between Demographic, Surgical, and Pathological Characteristics with Local Recurrence‐Free Survival for Surgical Resected Retroperitoneal Liposarcoma

Retroperitoneal Sarcoma Care in 2021

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