Is multimodality therapy necessary for the management of pure myxoid liposarcomas? A multi-institutional series of pure myxoid liposarcomas of the extremities and torso

J Surg Oncol. 2015 Feb;111(2):146-51. doi: 10.1002/jso.23786. Epub 2014 Sep 12.

Abstract

Background and objectives: The treatment of patients with pure (<5% round cell component) myxoid liposarcomas (pMLS) has not been well characterized. We hypothesized that multimodality therapy (oncological resection with radiation therapy) may not be necessary for pMLS.

Methods: Patients who underwent resection of localized pMLS at three institutions from 2000 to 2010 were identified and treatment variables were analyzed.

Results: Of 75 pts with pMLS, the median tumor size was 10 cm, the majority (95%) were deep tumors, and located in lower extremity. Radiation (XRT) was administered to 58 pts(77%). Comparing the no XRT to XRT patients, lower extremity location (77% vs. 79%, P=1.0), tumor size (13 vs. 11 cm, P=0.3), and positive margins (13% vs. 16%, P=1.0) were similar. The majority (82%) of patients not receiving XRT had deep tumors. After a median follow-up of 60 months, 2 pts (3%) developed local recurrence and 10 pts (13%) developed distant recurrence with a mean recurrence-free survival (RFS) and disease-specific survival (DSS) of 114 and 148 mos, respectively. In multivariate analyses, increasing age and tumor size were the only significant predictors of recurrence. XRT was not a significant predictor of RFS in multivariate analysis.

Conclusions: pMLS is an STS subtype with favorable tumor biology and an extremely low-rate of local recurrence. Our results suggest that multimodality therapy may not be necessary for all pMLS.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy / methods
  • Disease-Free Survival
  • Extremities / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Liposarcoma, Myxoid / mortality
  • Liposarcoma, Myxoid / pathology
  • Liposarcoma, Myxoid / therapy*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local*
  • Postoperative Complications
  • Registries
  • Retrospective Studies
  • Soft Tissue Neoplasms / mortality
  • Soft Tissue Neoplasms / pathology
  • Soft Tissue Neoplasms / therapy*
  • Torso / surgery
  • Young Adult