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Resection Status Does Not Impact Recurrence in Well-Differentiated Liposarcoma of the Extremity. Am Surg 2021 Nov;87(11):1752-1759

Date

11/12/2021

Pubmed ID

34758653

DOI

10.1177/00031348211054536

Scopus ID

2-s2.0-85119115004   1 Citation

Abstract

BACKGROUND: Well-differentiated liposarcoma (WDLPS) is a low-grade soft tissue sarcoma with a propensity for local recurrence. The necessity of obtaining microscopically free surgical margins (R0) to minimize local recurrence is not clear. This study evaluates recurrence-free survival (RFS) of extremity WDLPS in relation to resection margin status.

METHODS: A retrospective review of adult patients with primary extremity WDLPS at seven US institutions from 2000 to 2016 was performed. Patients with recurrent tumors or incomplete resection (R2) were excluded. Clinicopathologic factors were analyzed to assess impact on local RFS.

RESULTS: 97 patients with primary extremity WDLPS were identified. The majority of patients had deep, lower extremity tumors. Mean tumor size was 18.2±8.9cm. Patients were treated with either radical (76.3%) or excisional (23.7%) resections; 64% had R0 and 36% had microscopically positive (R1) resection margins. Ten patients received radiation therapy with no difference in receipt of radiation between R0 vs R1 groups. Thirteen patients (13%) developed a local recurrence with no difference in RFS between R0 vs R1 resection. Five-year RFS was 59.5% for R0 vs 85.2% for R1. Only one patient died of disease after developing dedifferentiation and distant metastasis despite originally having an R0 resection.

DISCUSSION: In this large multi-institutional study of surgical resection of extremity WDLPS, microscopically positive margins were not associated with an increased risk of recurrence. Positive microscopic margin resection for extremity WDLPS may yield similar rates of local control while avoiding a radical approach to obtain microscopically negative margins.

Author List

Olson CR, Suarez-Kelly LP, Ethun CG, Shelby RD, Yu PY, Hughes TM, Palettas M, Tran TB, Poultsides G, Tseng J, Roggin KK, Chouliaras K, Votanopoulos K, Krasnick BA, Fields RC, King DM, Bedi M, Pollock RE, Grignol VP, Cardona K, Howard JH

Authors

Manpreet Bedi MD, MS Associate Professor in the Radiation Oncology department at Medical College of Wisconsin
David M. King MD Chair, Professor in the Orthopaedic Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Arm
Disease-Free Survival
Female
Humans
Leg
Liposarcoma
Male
Margins of Excision
Middle Aged
Neoplasm Recurrence, Local
Retrospective Studies
Risk Factors
Soft Tissue Neoplasms