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Organ Infiltration and Patient Risk After Multivisceral Surgery for Primary Retroperitoneal Liposarcomas

  • Sarcoma
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The extent of histological organ involvement (HOI) to organs and structures of a retroperitoneal liposarcoma may have prognostic implications. This study investigated incidence, characteristics, and risk association of HOI in these patients.

Patients and Methods

Data of patients who underwent multivisceral resection for primary liposarcoma (2009–2014) were retrospectively analyzed. HOI was the variable of interest and was classified into four degrees: absent (HOI-0), perivisceral (HOI-1), initial (HOI-2), and advanced (HOI-3). Primary endpoint was overall survival (OS). Secondary endpoint was disease-free survival (DFS). The prognostic value of HOI was adjusted for preoperative treatment and the Sarculator nomogram score.

Results

A total of 109 patients were included. HOI-0, HOI-1, HOI-2, and HOI-3 were detected in 9 (8.3%), 11 (10.1%), 43 (39.4%), and 46 (42.2%) patients. Median follow-up was 8.4 years [interquartile range (IQR) 7.2–9.6 years]. There were 68 recurrences and 50 patient deaths observed, resulting in a 10-year OS and DFS of 51.1% [95% confidence interval (CI) 41.9–62.1%] and 34.1% (95% CI 25.2–46.1%), respectively. Clinically relevant HOIs (HOI-2 and HOI-3) were found in 35/45 (77.8%) and 54/64 (84.4%) cases of well- and de-differentiated liposarcomas, respectively. On multivariable survival analysis, patients with HOI-3 had significantly shorter OS (HOI-3 vs HOI-0/HOI-1 HR 2.92; p = 0.012) and DFS (HOI-3 vs HOI-0/HOI-1 HR 2.23; p = 0.045), independently of the nomogram score (OS: HR 2.93; p < 0.001; DFS: HR 1.78; p = 0.003).

Conclusions

Initial and advanced HOIs are frequently detected in both well-differentiated and de-differentiated liposarcomas, supporting that multivisceral resection may be needed. HOI stratifies the risk of patients with primary retroperitoneal liposarcoma.

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All relevant data are within the paper and its Supplementary Digital Content (SDC).

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Funding

This study was supported by the following research grants: “5x1000 Founds” – 2016, Italian Ministry of Health – Institutional Grant BRI2017 from Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, GR-2019-12369175, FRRB-584-797, 60, and International Accelerator Award funded by AIRC [ID #24297]/Cancer Research UK [C56167/A29363]/Fundacion Científica, Asociacion Espanola Contra el Cancer [Foundation AECC-GEACC19007MA]. L.I. research is supported by Fondazione Policlinico Universitario Campus Bio-Medico (Sarcoma Research Fund).

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Authors and Affiliations

  1. Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Luca Improta MD, Sandro Pasquali MD, PhD, Marco Fiore MD, FACS, Stefano Radaelli MD, Chiara Colombo MD, Dario Callegaro MD & Alessandro Gronchi MD

  2. Sarcoma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy

    Luca Improta MD, Rossana Alloni MD & Sergio Valeri MD

  3. Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Sandro Pasquali MD, PhD

  4. Department of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Sara Iadecola MSc & Rosalba Miceli MSc, PhD

  5. Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy

    Marta Barisella MD

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  1. Luca Improta MD
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  2. Sandro Pasquali MD, PhD
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Correspondence to Alessandro Gronchi MD.

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Disclosure

A.G. received compensation for Ad Boards from Novartis, Bayer, Lilly, PharmaMar, and SpringWorks, as well as honoraria from PharmaMar and Deciphera and research grants from PharmaMar and Nanobiotix. The other authors have declared that no competing interests exist.

Ethical approval

The study was approved by the Ethics Committee of Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy (INT 88/17).

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Improta, L., Pasquali, S., Iadecola, S. et al. Organ Infiltration and Patient Risk After Multivisceral Surgery for Primary Retroperitoneal Liposarcomas. Ann Surg Oncol 30, 4500–4510 (2023). https://doi.org/10.1245/s10434-023-13314-9

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