Myxoid liposarcoma: treatment outcomes, metastatic pattern and volumetric analysis.

IF 2.7 3区 医学 Q3 ONCOLOGY
Vlatko Potkrajcic, Merle Zschiegner, Maximilian Niyazi, Verena Warm, Johannes Tobias Thiel, Sandra Frantz, Christoph K W Deinzer, Franziska Szelat, Elgin Hoffmann, Frank Paulsen, Franziska Eckert
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引用次数: 0

Abstract

Background: Myxoid liposarcoma (MLPS) is a rare subtype of soft tissue sarcoma. This entity has a specific clinical behavior, characterized with a distinct pattern of hematogenous spread, as well as with a unique radiosensitivity and chemosensitivity. Oncologic results, metastatic patterns and treatment response after multimodal therapy were evaluated in a unicentric patient cohort.

Methods: Patients with myxoid liposarcoma were retrospectively analyzed in a single institution analysis (n = 31). Oncologic outcomes were evaluated in 28 patients with localized MLPS treated with multimodal therapy in curative intent. Metastatic pattern was analyzed in additional 3 patients with initially metastatic disease. In patients treated with concomitant MR-guided hyperthermia in the preoperative setting (n = 7), tumor size response was evaluated longitudinally during radio(-chemo)therapy in thermometry MRIs and before surgery (based on preoperative imaging).

Results: The median follow-up was 4.1 ± 1.0 years. The most common anatomic localization was the lower extremity (78.6%). The 5‑year rates for oncologic outcomes in 28 patients treated in curative intent were 91.7% (± 8.0%) for overall survival (OS), 77.4% (± 11.0%) for local control (LC), 60.1% (± 10.6%) for distant metastasis-free survival (DMFS) and 55.4% (± 11.1%) for disease free survival (DFS). Excellent 5‑year LC (94.7 ± 5.1%) was demonstrated for the cohort excluding 5 patients treated for local recurrences. Most patients had good pathologic response (< 10% vital tumor tissue) following neoadjuvant treatment (82.4%, 14/17). However, this did not correlate with oncologic outcomes. A specific pattern of distant metastases has been observed, with predilection for soft tissues as the most common metastatic site. Furthermore, no isolated pulmonary metastases were observed. The MR analysis demonstrated a significant tumor size reduction (≥ 25%) of the initial tumor volume in 85.7% (n = 6/7) patients. No local recurrences and no distant metastases were observed in patients with significant MR size reduction.

Conclusion: Sequential MRIs during preoperative radiotherapy of myxoid liposarcoma show distinct patterns of the known size reduction of this specific subentity. Our analysis of metastatic patterns demonstrate mostly soft tissue metastases, no patient experienced isolated pulmonary metastases.

黏液样脂肪肉瘤:治疗结果、转移模式和体积分析。
背景:粘液样脂肪肉瘤(MLPS)是一种罕见的软组织肉瘤亚型。该实体具有特定的临床行为,其特点是具有明显的血行扩散模式,以及独特的放射敏感性和化学敏感性。在单中心患者队列中评估多模式治疗后的肿瘤学结果、转移模式和治疗反应。方法:回顾性分析单一机构的黏液样脂肪肉瘤患者( = 31)。对28例采用多模式治疗的局限性MLPS患者的肿瘤预后进行了评估。对另外3例初始转移性疾病患者的转移模式进行了分析。在术前同时接受mri引导的热疗治疗的患者(n = 7),在放射(化疗)治疗期间和术前(基于术前成像)通过测温mri纵向评估肿瘤大小反应。结果:中位随访时间为4.1 ±1.0年。最常见的解剖定位是下肢(78.6%)。28例治疗目的患者的5年肿瘤预后率为总生存率(OS) 91.7%(± 8.0%),局部对照(LC) 77.4%(± 11.0%),远端无转移生存率(DMFS) 60.1%(± 10.6%),无疾病生存率(DFS) 55.4%(± 11.1%)。在排除5例局部复发患者的队列中,显示出优秀的5年LC(94.7 ±5.1%)。结论:术前放疗时对黏液样脂肪肉瘤的序贯mri显示出该特异性亚实体已知大小缩小的明显模式。我们对转移模式的分析显示大多数是软组织转移,没有患者经历过孤立的肺转移。
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来源期刊
CiteScore
5.70
自引率
12.90%
发文量
141
审稿时长
3-8 weeks
期刊介绍: Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research. Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.
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