Prognostic factors of patients with extremity myxoid liposarcomas after surgery
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(2019) 14:90
RESEARCH ARTICLE
Open Access
Prognostic factors of patients with extremity myxoid liposarcomas after surgery Jiaqi Wu, Shengjun Qian and Libin Jin*
Abstract Background: Extremity myxoid liposarcoma (MLS) is a rare soft tissue sarcoma in adults. We performed this study to define distinctive clinical features of extremity MLS by assessing prognostic factors. Methods: Between 1973 and 2015, 1756 patients with extremity MLS who underwent surgical resection were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database of the US National Cancer Institute. Both overall survival (OS) and cancer-specific survival (CSS) were assessed using the Kaplan–Meier method (to obtain OS and CSS curves) and a Cox proportional hazards regression model. Results: Of the 1756 patients with extremity MLS, the mean and median patient age at diagnosis were 47 and 45 years, respectively. More than half (n = 1027, 58.5%) of the patients were male. In terms of location, 10.5% tumors were located in the upper limbs and 89.5% in lower limbs. All patients received local surgery, and about half of the patients (57.2%) received radiation treatment. The 5- and 10-year OS rates of the entire cohort were 86.4% and 75.9%, respectively. The 5- and 10-year CSS rates were 90.5% and 85.2%, respectively. On multivariate analysis, older age, male gender, high tumor grade, and tumor size > 10 cm were found to be independent risk factors of both decreased OS and CSS. Year of diagnosis ≥ year 2000 was significantly associated with an increased CSS. In addition, radiation treatment failed to become an independent risk factor for either OS or CSS. Conclusion: We identified age, gender, tumor grade, year of diagnosis, and tumor size as independent prognostic factors for OS and CSS in patients with extremity MLS. Keywords: Myxoid liposarcoma, Extremity, Prognostic factors, Treatment
Background Liposarcoma (LPS) is the most common soft tissue sarcoma (STS) of the extremities in adults, and it is classified into four subtypes according to the 2013 WHO classification, namely, dedifferentiated, myxoid, pleomorphic, and not otherwise specified [1]. The round cell LPS type has been included in the myxoid LPS. Myxoid liposarcoma (MLS) is the second most common type of liposarcoma, accounting for 15–20% of all liposarcomas [2]. The demographic data and clinical outcomes of extremity LPS or STS are well documented [3–7]. Surgical resection is the mainstream * Correspondence: [email protected] Department of Orthopaedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou 310000, Zhejiang, People’s Republic of China
treatment for extremity LPS. However, adjunct radiotherapy (RT) plays an important role in the treatment of extremity LPS. Combination of surgery and adjuvant RT has been increasingly used to improve local control of the disease and decrease the recurrence [8]. In particular, MLS has been rep
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