Journal List > J Korean Bone Joint Tumor Soc > v.16(2) > 1051975

Lee, Cho, Yang, Suh, and Shin: Liposarcoma in the Extremity

Abstract

Purpose

We analyzed disease free survival and the prognostic factors of liposarcoma in the extremity.

Materials and Methods

Between 1994 and 2005, of 44 patients who were diagnosed and treated for liposarcoma of the extremity, 40 patients were restrospectively analysed. 13 out of 40 patients got postoperative radiotherapy. We examined local recurrence, distant metastasis and disease free 5-year survival rate. We also analyzed clinical prognostic factors, such as age, gender, size of tumor, prior unplanned excision, histologic type, surgical excision margin and postoperative radiotherapy respectively.

Results

There were 3 cases of local recurrence and 4 cases of distant metastasis. The disease free 5-year survival rate was 85.0%. 26 patients presented with myxoid, 8 well differentiated, 4 round cell, 1 pleomorphic and 1 dedifferentiated histology. The disease free 5-year survival rate of mixoid, well differentiated and round cell liposarcoma were 100.0%, 84.6% and 75.0% (p=0.419). The 5-year disease free survival rate was 90.6% in negative surgical margin (n=25) and 62.5% in positive surgical margin (n=15) (p=0.003).

Conclusion

Our study suggests that surgical excision margin is significant prognostic factor for 5-year disease free survival rate.

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Figure 1.
The round cell liposarcoma was diagnosed in the right thigh of 24 year old male patient. (A) T1-weighted axial MR image. (B) T2-weighted fat suppressed axial MR image. (C, D) Gross photos of liposarcoma. (E) Cross section of liposarcoma.
jkbjts-16-62f1.tif
Figure 2.
The graph shows the cumulative disease free survival of patients of liposarcoma in extremities. The 5-year disease free survival rate was 85.0%.
jkbjts-16-62f2.tif
Figure 3.
The graph shows disease free survival curve according to histological type of liposarcoma. The 5-year disease free survival rate of well-differentiated liposarcoma, mixoid liposarcoma and round cell liposarcoma were 100%, 84.6% and 75.0% respectively. The p-value was 0.419 in the log rank test.
jkbjts-16-62f3.tif
Figure 4.
The graph shows disease free survival curve according to surgical margin. The 5-year disease free survival rate of the negative margin was 90.6% and that of the positive margin was 62.5%. The p-value was 0.003 in the log rank test.
jkbjts-16-62f4.tif
Table 1.
Patient Characteristics
Variables Total (n=40) (%) LR DM LR or DM (n=7)(%)
Age        
 Mean (range) 47 (16-76)      
 Median 48      
Gender        
 Male 26 (65.0%) 1 3 4 (15.4%)
 Female 14 (35.0%) 2 1 3 (21.4%)
Presentation status        
 No prior biopsy or treatment 23 (57.5%) 1 3 4 (17.4%)
 Biopsy 4 (10.0%) 0 0 0 (0)
 Prior excision 13 (32.5%) 2 1 3 (23.1%)
Primary site        
 Arm 2 (5.0%) 0 0 0 (0)
 Buttock 2 (5.0%) 0 0 0 (0)
 Inguinal area 2 (5.0%) 0 0 0 (0)
 Thigh 31 (77.5%) 3 3 6 (19.4%)
 Popliteal area 1 (2.5%) 0 0 0 (0)
 Lower leg 2 (5.0%) 0 1 1 (50.0%)
Tumor size        
 Mean (cm, range) 12.4 (3.0-24.0)      
 Median 12      
Histologic variant        
 Well differentiated 8 (20.0%) 0 0 0 (0)
 Myxoid 26 (65.0%) 2 3 5 (19.2%)
 Round 4 (10.0%) 0 1 1 (25.0%)
 Pleomorphic 1 (2.5%) 0 0 0 (0)
 Dedifferentiated 1 (2.5%) 1 0 1 (100.0%)
Margins        
 Positive margins 8 (20.0%) 1 3 4 (50.0%)
 Negative margins 32 (80.0%) 2 1 3 (9.4%)
Postoperative radiotherapy for primary disease        
 Yes 13 (32.5%) 1 3 4 (33.3%)
 No 27 (67.5%) 2 1 3 (10.7%)

LR, local recurrence; DM, distant metastasis.

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