Intermuscular extremity myxoid liposarcoma can be managed by marginal resection following neoadjuvant radiotherapy.

Abstract

BACKGROUND:

Compared with other soft tissue sarcomas, myxoid liposarcoma (MLS) occurs in younger patients, has a propensity for intermuscular locations and is highly radiosensitive. With pre-operative radiotherapy, intermuscular MLS demonstrates substantial volume reduction and can be easily separated from surrounding tissues during resection. However, it is unclear whether marginal excision of MLS is oncologically safe. This study aimed to assess the association between margins and survival in irradiated, intermuscular MLS.

METHODS:

The study identified 198 patients from seven sarcoma centres with a first presentation of localized, extremity, intermuscular MLS that received pre-operative radiotherapy and was diagnosed between 1990 and 2017. Patient and treatment characteristics, radiological and histological responses to neoadjuvant treatment and clinical surveillance were recorded.

RESULTS:

Margins were microscopically positive in 11% (n = 22), <1.0 mm in 15% (n = 29) and ≥1.0 mm in 72% (n = 143). There was no association between margin status and local recurrence-free, metastasis-free or overall survival. This finding held true even in patients at higher risk of worse overall survival based on multivariable analysis (% round cell≥5%, percentage ellipsoid tumour volume change ≤ -60.1%).

CONCLUSION:

Irradiated, extremity, intermuscular myxoid liposarcoma can safely undergo marginal resection without compromising oncologic control.

• Authors: Jonathan R Perera, Meshal AlFaraidy, Izuchukwu Ibe, Ahmed Aoude, Ibtissam Acem, Michiel A J van de Sande, Mireille Dessureault, Robert E Turcotte, Sophie Mottard, Georges Basile, Marc Isler, Hugo Saint-Yves, Nicholas Eastley, Jonathan Stevenson, Matthew T Houdek, Peter W M Chung, Anthony M Griffin, Peter Ferguson, Jay S Wunder, Kim M Tsoi
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 49 Issue 2 Pg. 362-367 (02 2023) ISSN: 1532-2157 [Electronic] England
• PMID: 36243649 (Publication Type: Journal Article)
• Copyright: Copyright © 2022. Published by Elsevier Ltd.

Topics

• Adult
• Humans
• Liposarcoma, Myxoid (pathology)
• Neoadjuvant Therapy
• Treatment Outcome
• Liposarcoma
• Extremities (pathology)
• Sarcoma (surgery)
• Soft Tissue Neoplasms (surgery)
• Retrospective Studies
• Neoplasm Recurrence, Local (surgery)