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Diagnosis, Management, and Outcome of Patients with Dedifferentiated Liposarcoma Systemic Metastasis

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Dedifferentiated liposarcomas (DDLPSs) result in worse patient outcomes than well-differentiated tumors despite shared molecular derangements. Prevalence and pattern of DDLPS systemic metastases have not been extensively reported; information regarding diagnosis, treatment, and outcomes of metastatic DDLPS patients is limited. Our study seeks to address this knowledge gap.

Methods

Metastatic patients were identified from a clinical database consisting of 277 DDLPS patients treated at the University of Texas M D Anderson Cancer Center (UTMDACC) (1993–2010). Only patients with radiologically demonstrable distant metastases were included. Patient, tumor, treatment, and outcome variables were recorded. Available imaging studies and tumor FFPE blocks were assessed.

Results

A total of 40 patients were identified, translating into a DDLPS metastatic rate of 14% (17% for de novo DDLPS and 9% for secondary dedifferentiation). The average patient age was 61 years with a male predilection. The retroperitoneum and lungs were the most common primary and metastatic tumor sites. Any of the 4 described DDLPS morphological subtypes harbored metastatic potential; MFH/UPS-like morphology was the most common. The median time from primary diagnosis to metastasis was 25 months; more than 50% of metastases developed without local failure. The median survival of metastatic patients was 11.5 months; the 5-year DSS was 5.2%. Patients amenable to complete surgical extirpation (n = 14) faired significantly better (P = .001; log rank).

Conclusions

Metastatic spread is an ominous consequence of DDLPS, especially regarding de novo tumors. Occurring relatively early in the course of disease and exhibiting a pulmonary predilection, these lesions are highly aggressive and commonly fatal. Further studies to identify metastatic biomarkers are needed.

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Acknowledgment

We appreciate the expert assistance provided by Mr. Paul Cuevas in the preparation and submission of this manuscript, and Ms. Kim Vu is thanked for her aid in figure preparation. We highly appreciate the philanthropic support of the Lobo, Margolis, and Jackson families. A Deutsche Forschungsgemeinschaft Fellowship grant supported the work of MPG; a clinical fellowship grant from the King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia, and the Saudi Arabian Cultural Mission supported TA-Z; and, an AIRC fellowship grant supported CC’s work.

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Authors and Affiliations

  1. Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Markus P. Ghadimi MD, Tingsheng Peng MD, PhD, Chiara Colombo MD, Aviad Hoffman MD, Anna Zhang & Raphael E. Pollock MD, PhD

  2. The Sarcoma Research Center, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Markus P. Ghadimi MD, Tingsheng Peng MD, PhD, Chiara Colombo MD, Aviad Hoffman MD, Anna Zhang, Alexander J. Lazar MD, PhD, Raphael E. Pollock MD, PhD & Dina Lev MD

  3. Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Tariq Al-Zaid MD & Alexander J. Lazar MD, PhD

  4. Department of Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    John Madewell MD

  5. Division of Biostatistics, Dan L. Duncan Cancer Center, Baylor College, Houston, TX, USA

    Chad J. Creighton PhD & Yiqun Zhang MS

  6. Department of Cancer Biology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Dina Lev MD

Authors
  1. Markus P. Ghadimi MD
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  2. Tariq Al-Zaid MD
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  7. Chad J. Creighton PhD
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  9. Anna Zhang
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  10. Alexander J. Lazar MD, PhD
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  11. Raphael E. Pollock MD, PhD
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  12. Dina Lev MD
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Corresponding author

Correspondence to Dina Lev MD.

Additional information

M.P. Ghadimi and T. Al-Zaid contributed equally to the manuscript.

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Ghadimi, M.P., Al-Zaid, T., Madewell, J. et al. Diagnosis, Management, and Outcome of Patients with Dedifferentiated Liposarcoma Systemic Metastasis. Ann Surg Oncol 18, 3762–3770 (2011). https://doi.org/10.1245/s10434-011-1794-0

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  • DOI: https://doi.org/10.1245/s10434-011-1794-0

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