Diagnosis, management, and outcome of patients with dedifferentiated liposarcoma systemic metastasis

Markus P. Ghadimi, Tariq Al-Zaid, John Madewell, Tingsheng Peng, Chiara Colombo, Aviad Hoffman, Chad J. Creighton, Yiqun Zhang, Anna Zhang, Alexander J. Lazar, Raphael E. Pollock, Dina Lev

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)3762-3770
Number of pages9
JournalAnnals of Surgical Oncology
Volume18
Issue number13
DOIs
Publication statusPublished - Dec 2011

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Ghadimi, M. P., Al-Zaid, T., Madewell, J., Peng, T., Colombo, C., Hoffman, A., Creighton, C. J., Zhang, Y., Zhang, A., Lazar, A. J., Pollock, R. E., & Lev, D. (2011). Diagnosis, management, and outcome of patients with dedifferentiated liposarcoma systemic metastasis. Annals of Surgical Oncology, 18(13), 3762-3770. https://doi.org/10.1245/s10434-011-1794-0