Prognostic factors for localized, resectable liposarcomas (LPS) of the extremities or trunk wall.

Abstract

e20515 Background: Liposarcomas are one of the most common and well-defined type of soft tissue sarcomas. The aim of the study was to analyze prognostic factors having influence on the outcomes of localized, resectable LPS of extremities/trunk wall. Methods: Between 1996 and 2008 in tertiary cancer center 187 consecutive patients, aged (18-89 years) with localized LPS (106 primary LPS, 61 clinically recurrent tumor and 20 scar after non radical resection) were treated with surgery and radiotherapy (158 cases) or surgery alone (29 cases including 6 amputations). Median follow-up: 48 months. Results: 5-year overall survival (OS), disease-free survival (DFS) and local relapse-free survival (LRFS) rates were: 80%, 57% and 75%, respectively. We identified factors having negative influence on LRFS: tumor grade 2 or 3 (p=0.04), clinically recurrent tumor (p=0.01; 5-year LRFS rates for primary versus clinically recurrent tumor versus scar after primary non radical resection were 86.5%, 52.1%, 73.3%, respectively), resection margins R1 (p=0.01) and pathological subtype (p=0.03). In multivariate analyses we have found following independent negative prognostic factors for OS (AJCC stage ≥ IIb; HR 5.8, 95% CI 2.1-16.1, p=0.001), DFS (grade 3: HR 3.9, 95% CI 1.9-7.5, p=0.0001; clinical recurrence HR 2.2, 95% CI 1.3-3.7, p=0.003 and skin infiltration, HR 2.8, 95% CI 1.4-5.7, p=0.004) and LRFS (clinically recurrent tumor HR 2.8, 95% CI 1.4-5.8, p=0.004; R1 resection margins HR 2.1, 95% CI 1.01-4.3, p=0.04). Conclusions: We have confirmed the value of AJCC staging for predicting OS in extremity/trunk wall LPS. Radical re-resection of scar after non-radical primary tumor resection (+ radiotherapy) seems to improve DFS and LRFS in this type of soft tissue sarcomas.