Primary intrathoracic liposarcoma: a clinicopathologic study and prognostic analysis of 23 cases

Ming Chen, Jun Yang, Lei Zhu, Cao Zhou, Heng Zhao, Ming Chen, Jun Yang, Lei Zhu, Cao Zhou, Heng Zhao

Abstract

Background: Primary intrathoracic liposarcoma is an extremely rare malignancy as well as a rare histologic subtype of intrathoracic sarcoma. Relatively few reports appear in the world literatures. We explored the clinicopathologic features and prognostic factors of this tumor in this study.

Methods: We retrospectively analyzed the clinicopathological data of 23 patients with primary intrathoracic liposarcoma who were treated in Shanghai chest Hospital affiliated to Jiao Tong University, from January 2003 to March 2013. These patients were classified into three groups according to the distinct tumor locations, including mediastinum, pleura and lung liposarcoma. Also, these patients could be divided into four types, including well-differentiated, myxoid, dedifferentiated and pleomorphic liposarcoma. The influences of age, sex, tumor size, tumor location, tumor histologic type and therapy on the prognosis of the patients were analyzed.

Results: There were no significant difference for survival among distinct liposarcoma locations. However, significant difference for survival among distinct liposarcoma types were observed. Poor disease-free survival (DFS) was observed in the myxoid, pleomorphic and dedifferentiated types as compared to well-differentiated type (P = 0.038). Inferior overall-survival (OS) was observed in dedifferentiated, pleomorphic and myxoid types relative to well-differentiated type (P = 0.027). The radical surgery was a favorable prognostic factor for OS, as demonstrated by the better OS of the radical surgery group as compared to that of the non-radical surgery group ( P = 0.029). Notably, there were no significant differences for DFS and OS in other clinical parameters including tumor size, gender and age. In addition, radiotherapy and/or chemotherapy could not improve the prognosis of the patients receiving non-radical surgery or suffering from relapse.

Conclusions: The histological type and the radical surgery are the factors that influence the behavior and prognosis of liposarcoma. In general, radiotherapy and chemotherapy are believed to be ineffective therapeutic modalities for survival. So it is essential to completely resect the primary intrathoracic liposarcoma as radical cure of the disease.

Figures

Figure 1
Figure 1
Disease-free survival curves according to the tumor type. Poor DFS was observed in the myxoid, dedifferentiated and pleomorphic types as compared to well-differentiated type (P = 0.038).
Figure 2
Figure 2
Overall survival curves according to the tumor type. Inferior OS were observed in dedifferentiated, myxoid and pleomorphic types, relative to well-differentiated type ( P = 0.027).
Figure 3
Figure 3
Overall survival curves according to the surgery. The variable of surgery was a prognostic factor for OS, as demonstrated by the poor OS in the non-radical surgery group as compared to that of the radical surgery group ( P = 0.029).

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