{"title":"腹膜后脂肪肉瘤首次复发的预后因素及治疗方式。","authors":"Yoshiyuki Matsui, Shintaro Iwata, Konosuke Moritani, Aiko Maejima, Satoshi Nara, Yukinori Yamagata, Motokiyo Komiyama, Satoshi Kamio, Kan Yonemori, Akira Kawai, Hiroyuki Fujimoto","doi":"10.1007/s10147-025-02790-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aimed to identify prognostic factors and treatment patterns at the first recurrence of retroperitoneal liposarcoma (LPS).</p><p><strong>Methods: </strong>Medical records of 150 patients who underwent resection for primary retroperitoneal LPS were reviewed. Of the 94 patients with local or distant recurrence, prognostic factors and treatment approaches were retrospectively analyzed.</p><p><strong>Results: </strong>At recurrence, 41 patients underwent surgery, 12 received radiation, 23 received chemotherapy, 12 were under active surveillance, and 6 received best supportive care. In univariate analysis, well-differentiated primary tumors predicted better overall survival (OS) compared to dedifferentiated tumors (p = 0.004). Conversely, shorter recurrence-free survival (RFS) after initial surgery, smaller recurrent tumors at treatment, and high neutrophil-to-lymphocyte ratio (NLR) at recurrence were associated with poorer OS (p = 0.0418, 0.007, and 0.0475, respectively). Treatment decisions were influenced by RFS, time from recurrence to treatment, initial tumor differentiation, recurrence site, and multiplicity. Among those who had surgery for recurrence, 29.2% (12/41) showed a change in tumor differentiation. RFS was a significant predictor of this change (p = 0.026). Additionally, NLR at recurrence and the waiting period from recurrence to treatment were significant prognostic factors in surgically treated patients (p = 0.005 and 0.028, respectively).</p><p><strong>Conclusions: </strong>RFS, timing of treatment, initial tumor differentiation, and recurrence characteristics influence treatment choices at first recurrence. RFS may predict changes in tumor differentiation, while NLR at recurrence and the waiting period from recurrence to treatment are important prognostic indicators in patients undergoing surgery.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1641-1649"},"PeriodicalIF":2.8000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The prognostic factors and treatment patterns of the first recurrence of retroperitoneal liposarcoma.\",\"authors\":\"Yoshiyuki Matsui, Shintaro Iwata, Konosuke Moritani, Aiko Maejima, Satoshi Nara, Yukinori Yamagata, Motokiyo Komiyama, Satoshi Kamio, Kan Yonemori, Akira Kawai, Hiroyuki Fujimoto\",\"doi\":\"10.1007/s10147-025-02790-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aimed to identify prognostic factors and treatment patterns at the first recurrence of retroperitoneal liposarcoma (LPS).</p><p><strong>Methods: </strong>Medical records of 150 patients who underwent resection for primary retroperitoneal LPS were reviewed. Of the 94 patients with local or distant recurrence, prognostic factors and treatment approaches were retrospectively analyzed.</p><p><strong>Results: </strong>At recurrence, 41 patients underwent surgery, 12 received radiation, 23 received chemotherapy, 12 were under active surveillance, and 6 received best supportive care. In univariate analysis, well-differentiated primary tumors predicted better overall survival (OS) compared to dedifferentiated tumors (p = 0.004). Conversely, shorter recurrence-free survival (RFS) after initial surgery, smaller recurrent tumors at treatment, and high neutrophil-to-lymphocyte ratio (NLR) at recurrence were associated with poorer OS (p = 0.0418, 0.007, and 0.0475, respectively). Treatment decisions were influenced by RFS, time from recurrence to treatment, initial tumor differentiation, recurrence site, and multiplicity. Among those who had surgery for recurrence, 29.2% (12/41) showed a change in tumor differentiation. RFS was a significant predictor of this change (p = 0.026). Additionally, NLR at recurrence and the waiting period from recurrence to treatment were significant prognostic factors in surgically treated patients (p = 0.005 and 0.028, respectively).</p><p><strong>Conclusions: </strong>RFS, timing of treatment, initial tumor differentiation, and recurrence characteristics influence treatment choices at first recurrence. RFS may predict changes in tumor differentiation, while NLR at recurrence and the waiting period from recurrence to treatment are important prognostic indicators in patients undergoing surgery.</p>\",\"PeriodicalId\":13869,\"journal\":{\"name\":\"International Journal of Clinical Oncology\",\"volume\":\" \",\"pages\":\"1641-1649\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Clinical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10147-025-02790-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10147-025-02790-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
The prognostic factors and treatment patterns of the first recurrence of retroperitoneal liposarcoma.
Background: This study aimed to identify prognostic factors and treatment patterns at the first recurrence of retroperitoneal liposarcoma (LPS).
Methods: Medical records of 150 patients who underwent resection for primary retroperitoneal LPS were reviewed. Of the 94 patients with local or distant recurrence, prognostic factors and treatment approaches were retrospectively analyzed.
Results: At recurrence, 41 patients underwent surgery, 12 received radiation, 23 received chemotherapy, 12 were under active surveillance, and 6 received best supportive care. In univariate analysis, well-differentiated primary tumors predicted better overall survival (OS) compared to dedifferentiated tumors (p = 0.004). Conversely, shorter recurrence-free survival (RFS) after initial surgery, smaller recurrent tumors at treatment, and high neutrophil-to-lymphocyte ratio (NLR) at recurrence were associated with poorer OS (p = 0.0418, 0.007, and 0.0475, respectively). Treatment decisions were influenced by RFS, time from recurrence to treatment, initial tumor differentiation, recurrence site, and multiplicity. Among those who had surgery for recurrence, 29.2% (12/41) showed a change in tumor differentiation. RFS was a significant predictor of this change (p = 0.026). Additionally, NLR at recurrence and the waiting period from recurrence to treatment were significant prognostic factors in surgically treated patients (p = 0.005 and 0.028, respectively).
Conclusions: RFS, timing of treatment, initial tumor differentiation, and recurrence characteristics influence treatment choices at first recurrence. RFS may predict changes in tumor differentiation, while NLR at recurrence and the waiting period from recurrence to treatment are important prognostic indicators in patients undergoing surgery.
期刊介绍:
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.