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Annals of Surgical Oncology

, Volume 20, Issue 7, pp 2148–2155 | Cite as

Paratesticular Liposarcoma: Unusual Patterns of Recurrence and Importance of Margins

  • Melin J. Khandekar
  • Chandrajit P. Raut
  • Jason L. Hornick
  • Qian Wang
  • Brian M. Alexander
  • Elizabeth H. Baldini
Bone and Soft Tissue Sarcomas

Abstract

Background

Paratesticular liposarcoma (LPS) is a rare entity for which optimal treatment has not been defined. We sought to determine recurrence patterns and prognostic factors.

Methods

A total of 25 patients with localized paratesticular LPS between 1987 and 2009 were reviewed. Actuarial local-recurrence-free survival (LRFS), disease-free-survival (DFS), and overall survival (OS) were determined using the Kaplan–Meier method.

Results

LPS histology was well differentiated for 10 patients (40 %), de-differentiated for 14 (56 %), and pleomorphic for 1 (4 %). Final margins were positive in 8 patients (32 %). Radiation therapy (RT) was given to 10 patients; fields included inguinal canal ± scrotum and low pelvis. LRFS rates at 3 and 5 years were 76 and 67 %. The 3-year LRFS rates were lower in patients with positive margins compared with those with negative margins (29 vs 100 %, p = .0005) and in patients with recurrent versus primary disease (38 vs 83 %, p = .04). Among patients who received surgery and RT, margins remained a significant predictor of local recurrence (p = .009). Interestingly, recurrences in 4 patients tracked along gonadal vessels, and only 1 patient had a distant recurrence. OS at 5 years was 100 %.

Conclusions

For patients with localized paratesticular LPS, positive margins and presentation with recurrent disease are adverse prognostic factors for LRFS. LR for patients with positive margins is still high despite RT; thus aggressive surgery to attain negative margins should be attempted in all cases. The finding of regional recurrences along gonadal vessels should be validated, and imaging studies should be tailored to reflect potential patterns of disease at presentation and subsequent recurrence.

Keywords

Overall Survival Local Recurrence Positive Margin Liposarcoma Negative Margin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Melin J. Khandekar
    • 1
    • 7
  • Chandrajit P. Raut
    • 2
    • 3
  • Jason L. Hornick
    • 3
    • 4
  • Qian Wang
    • 5
  • Brian M. Alexander
    • 6
  • Elizabeth H. Baldini
    • 3
    • 6
  1. 1.Harvard Radiation Oncology Program, Brigham and Women’s HospitalBostonUSA
  2. 2.Division of Surgical OncologyBrigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical SchoolBostonUSA
  3. 3.Center for Sarcoma and Bone Oncology, Dana-Farber Cancer InstituteBostonUSA
  4. 4.Department of PathologyBrigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical SchoolBostonUSA
  5. 5.Senior Biometrician II, Beijing Novartis Pharma Co. LtdBeijingChina
  6. 6.Department of Radiation OncologyBrigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical SchoolBostonUSA
  7. 7.Department of Radiation OncologyMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

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