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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2023

29-12-2022 | Liposarcoma | Sarcoma

Lifelong Imaging Surveillance is Indicated for Patients with Primary Retroperitoneal Liposarcoma

Authors: Mark A. Eckardt, MD, Danielle S. Graham, MD, Kyle D. Klingbeil, MD, Serena Y. Lofftus, MD, Tyler R. McCaw, MD, PhD, Mark J. Bailey, MD, PhD, Charles J. Goldring, BA, Joseph K. Kendal, MD, Brian E. Kadera, MD, Scott D. Nelson, MD, Sarah M. Dry, MD, Anusha K. Kalbasi, MD, Arun S. Singh, MD, Bartosz Chmielowski, MD, Frederick R. Eilber, MD, Fritz C. Eilber, MD, Joseph G. Crompton, MD, PhD

Published in: Annals of Surgical Oncology | Issue 5/2023

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Abstract

Background

Surveillance imaging of patients with retroperitoneal liposarcoma (RP-LPS) after surgical resection is based on a projected risk of locoregional and distant recurrence. The duration of surveillance is not well defined because the natural history of RP-LPS after treatment is poorly understood. This study evaluated the long-term risk of recurrence and disease-specific survival (DSS) for a cohort of patients with at least 10 years of progression-free survival (10yr-PFS) from their primary resection.

Methods

The prospective University of California, Los Angeles (UCLA) Sarcoma Database identified RP-LPS patients with 10yr-PFS after initial resection. The patients in the 10yr-PFS cohort were subsequently evaluated for recurrence and DSS. The time intervals start at date of initial surgical resection. Cox proportional hazards models were used to determine factors associated with recurrence and DSS.

Results

From 1972 to 2010, 76 patients with RP-LPS had at least 10 years of follow-up evaluation. Of these 76 patients, 39 (51%) demonstrated 10yr-PFS. The median follow-up period was 15 years (range 10–33 years). Among the 10yr-PFS patients, 49% (19/39) experienced a recurrence at least 10 years after surgery. Of those who experienced recurrence, 42% (8/19) died of disease. Neither long-term recurrence nor DSS were significantly associated with age, sex, tumor size, LPS subtype, surgical margin, or perioperative treatment with radiation or chemotherapy.

Conclusion

Patients who have primary RP-LPS treated with surgical resection ± multimodality therapy face a long-term risk of recurrence and disease-specific death unacknowledged by current surveillance imaging guidelines. Among the patients with 10yr-PFS, 49% experienced a recurrence, and 42% of those died of disease. These findings suggest a need for lifelong surveillance imaging for patients with RP-LPS.
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Metadata
Title
Lifelong Imaging Surveillance is Indicated for Patients with Primary Retroperitoneal Liposarcoma
Authors
Mark A. Eckardt, MD
Danielle S. Graham, MD
Kyle D. Klingbeil, MD
Serena Y. Lofftus, MD
Tyler R. McCaw, MD, PhD
Mark J. Bailey, MD, PhD
Charles J. Goldring, BA
Joseph K. Kendal, MD
Brian E. Kadera, MD
Scott D. Nelson, MD
Sarah M. Dry, MD
Anusha K. Kalbasi, MD
Arun S. Singh, MD
Bartosz Chmielowski, MD
Frederick R. Eilber, MD
Fritz C. Eilber, MD
Joseph G. Crompton, MD, PhD
Publication date
29-12-2022
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 5/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-022-12977-0

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