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01-04-2015 | Bone and Soft Tissue Sarcomas

Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes

Authors: Naruhiko Ikoma, MD, Keila E. Torres, MD, PhD, Neeta Somaiah, MD, Kelly K. Hunt, MD, Janice N. Cormier, MD, MPH, William Tseng, MD, Dina Lev, MD, Raphael Pollock, MD, PhD, Wei Lien Wang, MD, Barry Feig, MD

Published in: Annals of Surgical Oncology | Issue 4/2015

Abstract

Background

Surgery is the primary treatment for all subtypes of retroperitoneal liposarcoma, but neoadjuvant therapy may be warranted in cases of dedifferentiated liposarcoma (DDLS), which has an increased risk of recurrence and metastasis. Therefore, an accurate subtype-specific diagnosis is vital for appropriate consideration of neoadjuvant therapy. Previous studies assessing the subtype-specific accuracy of percutaneous biopsy are limited. We aimed to analyze the accuracy of preoperative percutaneous biopsy in the subtype-specific diagnosis of retroperitoneal liposarcoma and thus the reliability of percutaneous biopsy in guiding decisions about neoadjuvant treatment.

Methods

We retrospectively reviewed the medical records, including the pathologic reports, interventional radiology reports, and operative reports, of patients registered in the retroperitoneal/well-differentiated liposarcoma (WDLS/DDLS) database at The University of Texas MD Anderson Cancer Center between 1993 and 2013.

Results

We identified 120 patients who underwent 137 preoperative percutaneous biopsies followed by surgical resections. Pathologic examination following resection indicated that 74 of the patients had WDLS and 63 had DDLS. The overall diagnostic accuracy of percutaneous biopsy for identifying the subtype of liposarcoma was 62.8 % (86/137); the accuracy for identifying WDLS was significantly higher (85.1 %; 63/74) than that for identifying DDLS (36.5 %; 23/63) (p < 0.01).

Conclusions

Percutaneous biopsy has low accuracy in the diagnosis of retroperitoneal DDLS. This can potentially mislead physicians in the decision to implement neoadjuvant treatment. When developing treatment strategies, including clinical trials for patients with retroperitoneal liposarcoma, physicians should carefully consider the low accuracy of percutaneous biopsy in detecting DDLS.

Crago AM, Singer S. Clinical and molecular approaches to well differentiated and dedifferentiated liposarcoma. Curr Opin Oncol. 2011;23(4):373–8.CrossRefPubMedCentralPubMed

Sioletic S, Dal Cin P, Fletcher CD, Hornick JL. Well-differentiated and dedifferentiated liposarcomas with prominent myxoid stroma: analysis of 56 cases. Histopathology. 2013;62(2):287–93.CrossRefPubMed

Lahat G, Tuvin D, Wei C, et al. New perspectives for staging and prognosis in soft tissue sarcoma. Ann Surg Oncol. 2008;15(10):2739–48.CrossRefPubMed

Singer S, Antonescu CR, Riedel E, Brennan MF. Histologic subtype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma. Ann Surg. 2003;238(3):358–70; discussion 70–1.PubMedCentralPubMed

Bonvalot S, Miceli R, Berselli M, et al. Aggressive surgery in retroperitoneal soft tissue sarcoma carried out at high-volume centers is safe and is associated with improved local control. Ann Surg Oncol. 2010;17(6):1507–14.CrossRefPubMed

Anaya DA, Lahat G, Wang X, et al. Postoperative nomogram for survival of patients with retroperitoneal sarcoma treated with curative intent. Ann Oncol. 2010;21(2):397–402.CrossRefPubMed

Russo P, Kim Y, Ravindran S, Huang W, Brennan MF. Nephrectomy during operative management of retroperitoneal sarcoma. Ann Surg Oncol. 1997;4(5):421–4.CrossRefPubMed

Pawlik TM, Pisters PW, Mikula L, et al. Long-term results of two prospective trials of preoperative external beam radiotherapy for localized intermediate- or high-grade retroperitoneal soft tissue sarcoma. Ann Surg Oncol. 2006;13(4):508–17.CrossRefPubMed

Pisters PW, O’Sullivan B. Retroperitoneal sarcomas: combined modality treatment approaches. Curr Opin Oncol. 2002;14(4):400–5.CrossRefPubMed

10.

Gronchi A, Lo Vullo S, Fiore M, et al. Aggressive surgical policies in a retrospectively reviewed single-institution case series of retroperitoneal soft tissue sarcoma patients. J Clin Oncol. 2009;27(1):24–30.CrossRefPubMed

11.

Bonvalot S, Rivoire M, Castaing M, et al. Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol. 2009;27(1):31–7.CrossRefPubMed

12.

Pisters PW. Resection of some—but not all—clinically uninvolved adjacent viscera as part of surgery for retroperitoneal soft tissue sarcomas. J Clin Oncol. 2009;27(1):6–8.CrossRefPubMed

13.

Bennert KW, Abdul-Karim FW. Fine needle aspiration cytology vs. needle core biopsy of soft tissue tumors: a comparison. Acta Cytol. 1994;38(3):381–4.PubMed

14.

Willen H, Akerman M, Carlen B. Fine needle aspiration (FNA) in the diagnosis of soft tissue tumours; a review of 22 years experience. Cytopathology. 1995;6(4):236–47.CrossRefPubMed

15.

Nikolaidis P, Silverman SG, Cibas ES, et al. Liposarcoma subtypes: identification with computed tomography and ultrasound-guided percutaneous needle biopsy. Eur Radiol. 2005;15(2):383–9.CrossRefPubMed

16.

Liles JS, Tzeng CW, Short JJ, Kulesza P, Heslin MJ. Retroperitoneal and intra-abdominal sarcoma. Curr Probl Surg. 2009;46(6):445–503.CrossRefPubMed

17.

Rekhi B, Navale P, Jambhekar NA. Critical histopathological analysis of 25 dedifferentiated liposarcomas, including uncommon variants, reviewed at a Tertiary Cancer Referral Center. Indian J Pathol Microbiol. 2012;55(3):294–302.CrossRefPubMed

18.

Evans HL. Atypical lipomatous tumor, its variants, and its combined forms: a study of 61 cases, with a minimum follow-up of 10 years. Am J Surg Pathol. 2007;31(1):1–14.CrossRefPubMed

19.

Coindre JM, Pedeutour F, Aurias A. Well-differentiated and dedifferentiated liposarcomas. Virchows Arch. 2010;456(2):167–79.CrossRefPubMed

20.

McCormick D, Mentzel T, Beham A, Fletcher CD. Dedifferentiated liposarcoma: clinicopathologic analysis of 32 cases suggesting a better prognostic subgroup among pleomorphic sarcomas. Am J Surg Pathol. 1994;18(12):1213–23.CrossRefPubMed

21.

Henricks WH, Chu YC, Goldblum JR, Weiss SW. Dedifferentiated liposarcoma: a clinicopathological analysis of 155 cases with a proposal for an expanded definition of dedifferentiation. Am J Surg Pathol. 1997;21(3):271–81.CrossRefPubMed

Title: Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes
Authors: Naruhiko Ikoma, MD
Keila E. Torres, MD, PhD
Neeta Somaiah, MD
Kelly K. Hunt, MD
Janice N. Cormier, MD, MPH
William Tseng, MD
Dina Lev, MD
Raphael Pollock, MD, PhD
Wei Lien Wang, MD
Barry Feig, MD
Publication date: 01-04-2015
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 4/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-4210-8

At a glance: The STEP trials

Springer Medicine

Accuracy of Preoperative Percutaneous Biopsy for the Diagnosis of Retroperitoneal Liposarcoma Subtypes

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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