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Analysis of Differentiation Changes and Outcomes at Time of First Recurrence of Retroperitoneal Liposarcoma by Transatlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG)

  • Sarcoma
  • Published:
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A Correction to this article was published on 19 March 2022

This article has been updated

Abstract

Background

Local recurrence following resection of retroperitoneal liposarcoma (RLPS) is common. Well-differentiated (WD) and dedifferentiated (DD) RLPS are distinct entities with differing outcomes. A few reports suggest that WDLPS can recur as DDLPS and that DDLPS can recur as WDLPS. This study evaluates whether this change in differentiation from the primary tumor to the first local recurrence impacts long-term outcomes.

Methods

Retrospective review from 22 sarcoma centers identified consecutive patients who underwent resection for a first locally recurrent RLPS from January 2002 to December 2011. Outcomes measured included overall survival, local recurrence, and distant metastasis.

Results

A total of 421 RPLS patients were identified. Of the 230 patients with primary DDLPS, 34 (15%) presented WDLPS upon recurrence (DD → WD); and of the 191 patients with primary WDLPS, 54 (28%) presented DDLPS upon recurrence (WD → DD). The 6-year overall survival probabilities (95% CI) for DD → DD, DD → WD, WD → WD, and WD → DD were 40% (32–48%), 73% (58–92%), 76% (68–85%), and 56% (43–73%) (p < 0.001), respectively. The 6-year second local recurrence incidence was 66% (59–73%), 63% (48–82%), 66% (57–76%), and 77% (66–90%), respectively. The 6-year distant metastasis incidence was 13% (9–19%), 3% (0.4–22%), 5% (2–11%), and 4% (1–16%), respectively. On multivariable analysis, DD → WD was associated with improved overall survival when compared with DD → DD (p < 0.001). Moreover, WD → DD was associated with a higher risk of LR (p = 0.025)

Conclusion

A change in RLPS differentiation from primary tumor to first local recurrence appears to impact survival. These findings may be useful in counseling patients on their prognosis and subsequent management.

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Authors and Affiliations

  1. Department of Surgery, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada

    Carolyn Nessim

  2. Department of Surgery, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, USA

    Chandrajit P. Raut MD, MSc & Mark Fairweather MD

  3. Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Dario Callegaro MD, Marco Fiore MD & Alessandro Gronchi MD

  4. Department of Applied Research and Technological Development, Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Francesco Barretta PhD & Rosalba Miceli PhD

  5. Department of Medical Oncology, Center Léon Bérard Cancer Center, Lyon, France

    Jean-Yves Blay MD

  6. Department of Surgery, Royal Marsden Hospital NHS Foundation Trust, London, UK

    Dirk Strauss MD

  7. Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

    Piotr Rutkowski MD, PhD

  8. Department of Surgery, Yale School of Medicine, New Haven, CT, USA

    Nita Ahuja MD, MBA

  9. John Hopkins University School of Medicine, Baltimore, MD, USA

    Nita Ahuja MD, MBA

  10. Department of Surgery, Moffitt Cancer Center, Tampa, FL, USA

    Ricardo Gonzalez MD

  11. Division of Medical Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, TO, Italy

    Giovanni Grignani MD

  12. Department of Surgery, Istituto Clinico Humanitas IRCCS, Milan, Italy

    Vittorio Quagliuolo MD

  13. Department of Surgery, Institut Bergonié, Bordeaux, France

    Eberhard Stoeckle MD

  14. Department of Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel

    Guy Lahat MD

  15. Department of Radiation Oncology, Centro di Riferimento Oncologico, Aviano, Italy

    Antonino De Paoli MD

  16. Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA

    Venu G. Pillarisetty MD

  17. Department of Surgery, UC Davis Health, Sacramento, CA, USA

    Robert J. Canter MD

  18. Department of Surgery, Massachusetts General Hospital, Boston, MA, USA

    John T. Mullen

  19. Division of Melanoma, Sarcomas and Rare Tumors, IEO, European Institute of Oncology, IRCCS, Milan, Italy

    Elisabetta Pennacchioli MD

  20. Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands

    Winan van Houdt MD, MS, PhD & Yvonne Schrage MD, PhD

  21. Department of Surgery, Mount Sinai Hospital and Princess Margaret Cancer Center, Toronto, Canada

    Carol J. Swallow MD, PhD & Yvonne Schrage MD, PhD

  22. Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands

    Yvonne Schrage MD, PhD

  23. Department of Surgery, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA

    Kenneth Cardona MD

  24. Department of Surgery, Mayo Clinic, Jacksonville, FL, USA

    Sanjay P. Bagaria MD

Authors
  1. Carolyn Nessim
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  2. Chandrajit P. Raut MD, MSc
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  3. Dario Callegaro MD
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  4. Francesco Barretta PhD
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  5. Rosalba Miceli PhD
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  6. Mark Fairweather MD
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  7. Jean-Yves Blay MD
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  8. Dirk Strauss MD
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  9. Piotr Rutkowski MD, PhD
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  10. Nita Ahuja MD, MBA
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  11. Ricardo Gonzalez MD
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  12. Giovanni Grignani MD
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  13. Vittorio Quagliuolo MD
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  14. Eberhard Stoeckle MD
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  15. Guy Lahat MD
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  16. Antonino De Paoli MD
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  17. Venu G. Pillarisetty MD
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  18. Robert J. Canter MD
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  19. John T. Mullen
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  20. Elisabetta Pennacchioli MD
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  21. Winan van Houdt MD, MS, PhD
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  22. Carol J. Swallow MD, PhD
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  23. Yvonne Schrage MD, PhD
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  24. Kenneth Cardona MD
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  25. Marco Fiore MD
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  26. Alessandro Gronchi MD
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  27. Sanjay P. Bagaria MD
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Corresponding author

Correspondence to Carolyn Nessim.

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Disclosures

P.R.: honoraria for lectures and Advisory Boards from Novartis, BMS, MSD, Pierre Fabre, Sanfoi, Merck, Pfizer, and Blueprint Medicines. N.A.: consultant for Cepheid; grant funding from Van Andel Research Institute – Stand Up To Cancer Epigenetics Dream Team. Stand Up To Cancer is a program of the Entertainment Industry Foundation, administered by AACR; she is a member of the Scientific Advisory Council to the No Stomach for Cancer Foundation, and sits on the Yale New Haven Hospital Board of Trustees; licensed methylation biomarkers to Cepheid (Patent No. 10167513); shares in Coca-Cola and IBM; her spouse is an IBM employee, and owns a private technology company. G.G.; grants from: Bayer, Pharmamar, Novartis. Personal fees: Novartis, Bayer, Pharmamar, Lilly, EISAI, Merck, and Tesaro. This paper was accepted as an Oral Presentation at the Society of Surgical Oncology Annual Cancer Symposium, Virtual August 17–18, 2020 and voted amongst the Best of SSO 2020.

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The original online version of this article was revised: Elisabetta Pennacchioli’s affiliation was corrected.

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Nessim, C., Raut, C.P., Callegaro, D. et al. Analysis of Differentiation Changes and Outcomes at Time of First Recurrence of Retroperitoneal Liposarcoma by Transatlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG). Ann Surg Oncol 28, 7854–7863 (2021). https://doi.org/10.1245/s10434-021-10024-y

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