DOS BULLETIN - Dansk Ortopædisk Selskab

2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 112
Metastatic pattern, local relapse and survival of
patients with myxoid liposarcoma
Hanna M Fuglø, Søren Daugaard, Michael M Petersen
Department of Orthopaedic Surgery, Rigshospitalet;
Department of Pathology, Rigshospitalet
Background: Sarcomas are rare tumors accounting for approximately
1% of all malignant tumors in adults, and 4/5 are soft tissue sarcomas. In
general the metastatic pattern of soft tissue sarcomas are hematogenic to
the lungs, and the recommended follow-up for metastases in these
patients is routine chest X-rays.
Purpose: To assess the metastatic pattern of the histological subtype
myxoid liposarcoma, and evaluate the metastases-free survival, local
relapse-free survival and overall survival.
Methods: Twenty-five patients (F/M = 12/13, mean age 50 (24-85) years)
were diagnosed with a myxoid liposarcoma at the Department of
Orthopaedic Surgery, Rigshospitalet from 1995-2004 (1995- 1999 (n=7),
2000-2004 (n=18)). In 2010 a retrospective review of patient files combined
with an extraction of survival data from the CPR-registret were performed.
The following parameters were recorded: tumor localization, size
and depth; classification of tumor; surgical margin; type of treatment,
type and time of follow-up; distant metastases; local relapse, and final
health status (death/alive). Statistics: Kaplan-Meier survival analysis.
Findings: Six patients had metastases during the observation period. Two
patients had metastases at the time of diagnosis, while metastases
occurred within 2-3 years in 3 patients and in one patient 11.9 years after
the primary diagnosis. We found an unusual metastatic pattern since all
metastases occurred at extra- pulmonary sites (intraabdominally/peritoneally,
spine, chest wall, mediastinum, paravertebraly, and cutaneously).
The probability for metastasis-free 5 and 10 years survival was 79%.
Five patients had local relapse, and the first local relapse occurred within
2 years after surgery in 4 patients. The probability for 5 and 10 years
local relapse-free survival was respectively 81% and 72 %. The probability
for overall survival after 5 and 10 years was 72% and 68 % respectively.
Conclusion: In this study the patients with myxoid liposarcoma had only
extrapulmonary metastases, and no metastases of the lungs. Most local
relapses and distant metastases occured within the first 2-3 years after
surgery. We suggest that follow-up of patients suffering from myxoid
liposarcoma should also include imaging of the abdomen/pelvis.
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