Tissue expander placement and adjuvant radiotherapy after surgical resection of retroperitoneal liposarcoma offers improved local control

Medicine (Baltimore). 2016 Aug;95(32):e4435. doi: 10.1097/MD.0000000000004435.

Abstract

Given that retroperitoneal liposarcoma (LPS) is extremely difficult to completely resect, and has a relatively high rate of recurrence, radiotherapy (RT) is the treatment of choice after surgical resection. However, it is difficult to obtain a sufficient radiation field because of the close proximity of surrounding organs. We introduce the use of tissue expanders (TEs) after LPS resection in an attempt to secure a sufficient radiation field and to improve recurrence-free survival.This study is a retrospective review of 53 patients who underwent surgical resection of LPS at Samsung Medical Center between January 1, 2005, and December 31, 2012, and had no residual tumor detected 2 months postoperatively. The median follow-up period was 38.9 months.Patients were divided into 3 groups. Those in group 1 (n = 17) had TE inserted and received postoperative RT. The patients in group 2 (n = 9) did not have TE inserted and received postoperative RT. Finally, those in group 3 (n = 27) did not receive postoperative RT. Multivariate analysis was performed to identify the risk factors associated with recurrence-free survival within 3 years. Younger age, history of LPS treatment, and RT after TE insertion (group 1 vs group 2 or 3) were significantly favorable factors influencing 3-year recurrence-free survival.TE insertion after LPS resection is associated with increased 3-year recurrence-free survival, most likely because it allows effective delivery of postoperative RT.

MeSH terms

  • Adult
  • Combined Modality Therapy / methods
  • Disease-Free Survival
  • Female
  • Humans
  • Liposarcoma / diagnostic imaging
  • Liposarcoma / therapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / prevention & control
  • Radiotherapy, Adjuvant / methods
  • Retroperitoneal Neoplasms / diagnostic imaging
  • Retroperitoneal Neoplasms / therapy*
  • Retrospective Studies
  • Risk Factors
  • Tissue Expansion Devices*
  • Tomography, X-Ray Computed

Supplementary concepts

  • Retroperitoneal liposarcoma