Oncology Medical News about extrimity myxoid liposarcoma;radiosensitivity;local control

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Radiosensitivity translates into excellent local control in extremity myxoid liposarcoma
Cancer, 06/02/09

Chung PWM et al. - In a trial to explore the multidisciplinary treatment of extremity myxoid liposarcoma compared with a contemporary cohort of other soft tissue sarcomas (STS) subtypes with an emphasis on the role of radiotherapy (RT) in improving local control, it was shown that multidisciplinary management of extremity STS achieves high rates of local control. Myxoid liposarcoma is associated with higher rates of local control compared with other STS subtypes, after combined surgery and radiation, suggesting a particular radiosensitivity that can be exploited to improve oncologic outcome in appropriate cases.

Methods

691 pts were identified from a prospective STS database who underwent combined management for localized extremity STS and were followed for a minimum of 12 mos or until death.
All pts underwent surgery together with pre or postoperative RT, depending on their presenting characteristics and resection margins.
Demographics and outcomes were compared between pts with myxoid liposarcoma and other STS subtypes (other-STS).

Results

88 of 691 pts had myxoid liposarcoma and 603 had other STS subtypes (other-STS).
Median follow-up was 86 and 61 mos, respectively.
For myxoid liposarcoma and other-STS groups, preoperative RT was used in 57% vs 61% of pts and postoperative RT in 43% vs 39%, respectively.
5-yr local recurrence-free survival was 97.7% for pts with myxoid liposarcoma compared with 89.6% for pts with other-STS tumors.
High-grade tumors were present in 7% and 59% of myxoid liposarcoma and other-STS pts, respectively.
2 myxoid liposarcoma pts with local recurrence had positive resection margins, whereas only 33% of pts in the other-STS group who developed a local recurrence had positive resection margins.
No pts with myxoid liposarcoma required amputation as primary management, whereas 8 (1.3%) required amputation as primary management in the other-STS group.
Systemic disease control was superior in myxoid liposarcoma compared with other-STS patients, with 5-yr overall and metastasis-free survival rates of 93.9% vs 76.4% and 89.1% vs 66.0%, respectively.
Of 12 myxoid liposarcoma pts with distant metastases, 7 appeared in nonpulmonary sites.
205 (34%) pts with other-STS tumors developed systemic disease but 78% had pulmonary metastases.

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