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Magnetic resonance imaging assessment of chemotherapy-related adipocytic maturation in myxoid/round cell liposarcomas: specificity and prognostic value.

AbstractOBJECTIVE:
To investigate the specificity, clinical implication and prognostic value of MRI adipocytic maturation (MAM) in myxoid/round cells liposarcomas (MRC-LPS) treated with neoadjuvant chemotherapy (NAC).
METHODS:
Of the 89 patients diagnosed with MRC-LPS at our sarcoma reference center between 2008 and 2018, 28 were included as they were treated with NAC, surgery and radiotherapy. All patients underwent contrast-enhanced MRIs at baseline and late evaluation. A control cohort of 13 high-grade pleomorphic and dedifferentiated LPS with same inclusion criteria was used to evaluate the specificity of MAM in MRC-LPS. Two radiologists analyzed the occurrence of MAM, changes in the tumor architecture, shape and surrounding tissues during NAC. Pathological features of tumor samples were reviewed and correlated with MRI. Metastatic relapse-free survival was estimated with Kaplan-Meier curves and Cox models. Associations between prognostic T1-based delta-radiomics features and MAM were investigated with Student t-test.
RESULTS:
MAM was more frequent in MRC-LPS (p = 0.045) and not specific of any type of chemotherapy (p = 0.7). Regarding MRC-LPS, 14 out of 28 patients (50%) demonstrated MAM. Eight patients showed metastatic relapses. MAM was not associated with metastatic relapse-free survival (p = 0.9). MAM correlated strongly with the percentage of histological adipocytic differentiation on surgical specimen (p < 0.001), which still expressed the tumor marker NY-ESO-1. None of the prognostic T1-based delta-radiomics features was associated with MAM.
CONCLUSION:
MAM seems a neutral event during NAC.
ADVANCES IN KNOWLEDGE:
MAM predominated in MRC-LPS and was not specific of a type of chemotherapy. Occurrence of MAM was not associated with better patients' metastasis free survival.
AuthorsAmandine Crombe, Maxime Sitbon, Eberhard Stoeckle, Antoine Italiano, Xavier Buy, François Le Loarer, Michèle Kind
JournalThe British journal of radiology (Br J Radiol) Vol. 93 Issue 1110 Pg. 20190794 (Jun 2020) ISSN: 1748-880X [Electronic] England
PMID32105502 (Publication Type: Journal Article)
Chemical References
  • Anthracyclines
  • Antineoplastic Agents
  • Contrast Media
Topics
  • Adipocytes (drug effects, pathology)
  • Adult
  • Aged
  • Anthracyclines (therapeutic use)
  • Antineoplastic Agents (therapeutic use)
  • Cell Differentiation (drug effects)
  • Chemotherapy, Adjuvant
  • Contrast Media
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liposarcoma, Myxoid (diagnostic imaging, drug therapy, pathology, therapy)
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Proportional Hazards Models
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tumor Burden

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