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

Journal of Cardiothoracic Surgery

Heng Zhao²  Cao Zhou²  Lei Zhu¹  Jun Yang²  Ming Chen² 

[1] Department of Pathology Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China;Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, 241 West HuanHai Road, Shanghai, China

关键词: Disease-free survival;    Overall survival;    Radical surgery;    Histological type;    Intrathoracic liposarcoma;   

Others  :  823177
DOI  :  10.1186/1749-8090-9-119

 received in 2014-04-25, accepted in 2014-06-29,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Chen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Carroll F, Kramer MD, Acinapura AJ, Tietjen PA, Wagner I, Oiseth S, Smith F: Pleural liposarcoma presenting with respiratory distress and suspected diaphragmatic hernia. Ann Thorac Surg 1992, 54:1212-1213.
• [2]Wong WW, Pluth JR, Grado GL, Schild SE, Sanderson DR: Liposarcoma of the pleura. Mayo Clin Proc 1994, 69:882-888.
• [3]Sekine Y, Hamaguchi K, Miyahara Y, Baba M, Yasufuku K, Fujisawa T, Yamaguchi Y: Thymus-related liposarcoma:report of a case and review of the literature. Surg Today 1996, 26:203-207.
• [4]Enzinger F, Weiss SW: Liposarcomas. In Soft Tissue Tumors. 3rd edition. St. Louis: CV Mosby; 1995:431-466.
• [5]Shmookler BM, Enzinger FM: Liposarcoma occuring in children.an analysis of 17 cases and review of the literature. Cancer 1983, 52:567-574.
• [6]Sung MS, Kang HS, Suh JS, Lee JH, Park JM, Kim JY, Lee HG: Myxoid liposarcoma: appearance at MR imaging with histologic correlation. Radiographics 2000, 20:1007-1019.
• [7]Gordon MS, Hajdu SI: Bains MS,15, Burt ME. Soft tissue sarcomas of the chest wall: results of surgical resection. J Thorac Cardiovasc Surg 1991, 101:843-854.
• [8]Sawamura K, Hashimoto T, Nanjo S, Nakamura K, Iioka S, Mori T, Furuse K, Shakudo Y: Primary liposarcoma of the lung; report of a case. J Surg Oncol 1982, 19:243-246.
• [9]Okurnori M, Mabuchi M, Nakagawa M: Malignant thymoma associated with liposarcoma of the mediastinum. A case report. Jpn J Surg 1983, 13:512-518.
• [10]Cicciarelli FE, Soule EH, McGoon DC: Lipoma and liposarcoma of the mediastinum: a report of 14tumors including one lipoma of the thymus. J Thorac Cardiovasc Surg 1964, 47:411.
• [11]Ibe T, Otani Y, Shimizu K, Nakano T, Sano T, Morishita Y: Pulmonary pleomorphic liposarcoma. Jpn J Thorac Cardiovasc Surg 2005, 53:443-447.
• [12]Krygier G, Amado A, Salisbury S, Fernandez I, Maedo N, Vazquez T: Primary lung liposarcoma. Lung Cancer 1997, 17:271-275.
• [13]Loddenkemper C, Perez-Canto A, Leschber G, Stein H: Primary dedifferentiated liposarcoma of the lung. Histopathol 2005, 46:710-712.
• [14]Mikkilineni RS, Bhat S, Cheng AW, Prevosti LG: Liposarcoma of the posterior mediastinum in a child. Chest 1994, 106:1288-1289.
• [15]Hirai S, Hamanaka Y, Mitsui N, Uegami S, Matsuura Y: Surgical resection of primary liposarcoma of the anterior mediastinum. Ann Thorac Cardiovasc Surg 2008, 14(1):38-41.