The Clinical Treatment And Prognosis Analysis Of Retroperitoneal Liposarcoma

Objective: This study aims to summarize the experience of retroperitoneal liposarcoma in clinical diagnosis and surgical management,and to explore its related factors associated with the recurrence,overall survival and subtype transformation.Methods: A total of 52 retroperitoneal liposarcoma patients who underwent surgical resection in the Shanghai Jiao Tong University Affiliated Sixth People’s Hospital between June 2003 and December 2018 were reviewed retrospectively and followed up.Statistical methods were used to analyze the independent risk factors of patients’ prognosis,recurrence and subtype transformation.Results: The completed resection rate of 52 patients with retroperitoneal liposarcoma is 88.5%,the recurrence rate is 53.8% and the metastasis rate 7.7%.The median overall survival of those patients after surgery was 53 months.Immunohistochemical results revealed that Ki-67 was expressed in all patients,and there is a negative correlation between Ki-67 expression index and Disease-free survival time of patients with retroperitoneal liposarcoma.S-100 was predominantly expressed in patients with low-grade retroperitoneal liposarcoma.COX multivariate analysis demonstrated that complete resection(P < 0.001),tumor recurrence(P < 0.033)and histologic grade(P < 0.020)were independent risk factors for overall survival of patients with retroperitoneal liposarcoma.COX multivariate analysis of the influence factors of DFS showed that histologic grade(P < 0.001),Ki-67 index(P < 0.001)and methods of operation(P < 0.015)were independent risk factors.The related factors that associated with the subtype transformation were analyzed by Logistic regression analysis,the results showed that intratumoral necrosis(P=0.043,OR=0.037)was the important factor related to the transformation of retroperitoneal liposarcoma subtypes.Conclusion: Complete surgical resection is still the most effective treatment for retroperitoneal liposarcoma,which can effectively reduce the risk of postoperative recurrence and improve its prognosis.Patients with high risk of recurrence with high malignant degree and high expression of Ki-67 should be closely followed up,and radiotherapy,chemotherapy and immunotherapy should be considered as appropriate.