Abstract
BACKGROUND: Retroperitoneal dedifferentiated liposarcoma is associated with a high risk of recurrence; however, treatment strategies that are more effective than surgery remain to be established. This study aimed to determine the optimal number of surgeries that would be effective in patients with recurrent disease. Furthermore, the improvement in the prognosis was evaluated according to the malignancy level.
METHODS:
The impact of each type of surgery on the prognosis of 118 patients with retroperitoneal dedifferentiated liposarcoma treated at our hospital was investigated. Among these 118 patients, 103 underwent an initial surgery. Fifty-four and 30 patients underwent a second and third surgery, respectively. The overall and disease-free survival rates of each group were compared using the Kaplan–Meier method the log-rank test was used to determine statistical significance in univariate analysis. 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) was used for the assessment of malignancy. The maximum standardized uptake value (SUVmax) of ≥4 and <4 was classified as high and low malignancy, respectively.
RESULTS: The first and second surgeries resulted in a significant improvement in the overall survival rate, despite the malignancy level (p <0.001); however, no significant improvement in prognosis was observed after the third surgery (p = 0.077). Low-grade malignancies were associated with a better postoperative prognosis, even in cases with recurrence; in contrast, high-grade malignancies exhibited a reduction in surgical efficacy.
CONCLUSIONS: Surgical treatment can prolong overall survival, even in cases with recurrence; however, it is advisable to assess the malignancy levels when determining the suitability of surgery beyond the second recurrence.