Intermuscular extremity myxoid liposarcoma can be managed by marginal resection following neoadjuvant radiotherapy: Marginal resection of irradiated myxoid liposarcoma

Jonathan R. Perera*, Meshal AlFaraidy, Izuchukwu Ibe, Ahmed Aoude, Ibtissam Acem, Michiel A.J. van de Sande, Mireille Dessureault, Robert E. Turcotte, Sophie Mottard, Georges Basile, Marc Isler, Hugo Saint-Yves, Nicholas Eastley, Jonathan Stevenson, Matthew T. Houdek, Peter W.M. Chung, Anthony M. Griffin, Peter Ferguson, Jay S. Wunder, Kim M. Tsoi

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Compared with other soft tissue sarcomas, myxoid liposarcoma (MLS) occurs in younger patients, has a propensity for intermuscular locations and is highly radiosensitive. With pre-operative radiotherapy, intermuscular MLS demonstrates substantial volume reduction and can be easily separated from surrounding tissues during resection. However, it is unclear whether marginal excision of MLS is oncologically safe. This study aimed to assess the association between margins and survival in irradiated, intermuscular MLS. Methods: The study identified 198 patients from seven sarcoma centres with a first presentation of localized, extremity, intermuscular MLS that received pre-operative radiotherapy and was diagnosed between 1990 and 2017. Patient and treatment characteristics, radiological and histological responses to neoadjuvant treatment and clinical surveillance were recorded. Results: Margins were microscopically positive in 11% (n = 22), <1.0 mm in 15% (n = 29) and ≥1.0 mm in 72% (n = 143). There was no association between margin status and local recurrence-free, metastasis-free or overall survival. This finding held true even in patients at higher risk of worse overall survival based on multivariable analysis (% round cell≥5%, percentage ellipsoid tumour volume change ≤ -60.1%). Conclusion: Irradiated, extremity, intermuscular myxoid liposarcoma can safely undergo marginal resection without compromising oncologic control.

Original languageEnglish
JournalEuropean Journal of Surgical Oncology
DOIs
Publication statusE-pub ahead of print - 27 Sep 2022

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