THE PROGNOSTIC SIGNIFICANCE OF MYXOID MATRIX IN RETROPERITONEAL WELL-DIFFERENTIATED LIPOSARCOMA
https://doi.org/10.21294/1814-4861-2021-20-1-46-52
Abstract
Objective: to assess the influence of the myxoid matrix in retroperitoneal well-differentiated liposarcoma
(WDLPS ) on the long-term results of surgical treatment of patients.
Material and Methods. The study included 111 patients with primary retroperitoneal WDLPS who underwent radical surgical treatment in Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» of the Ministry of Health of the Russian Federation. Histological slides of all surgical specimens were reviewed by experienced pathologist and reclassified according to criteria of WHO (2013) for histological subtypes of the WDLPS . Patients were divided into groups depending on presence or absence of the myxoid matrix in WDLPS and enrolled in intergroup analysis of overall (OS ) and recurrence-free (RFS) survival.
Results. OS was significantly worse in the group of patients with the myxoid matrix in the tumor (p=0.002; log-rank test). The median OS was 142 (95 % CI , 108, 176) months in the group without the myxoid matrix, and 84 (95 % CI , 29, 139) months in the group with the myxoid matrix. The 5-year survival rates were 79 % and 44 % in the groups without myxoid matrix and with myxoid matrix, respectively. RFS was also significantly worse in the group of patients with the myxoid matrix than in the group of patients without the myxoid matrix (p=0.006; log-rank test). The median RFS was 55 (95 % CI , 38, 72) months in the WDLPS group without the myxoid matrix, and 31 (95 % CI , 15, 47) months in the WDLPS group with the myxoid matrix. The 2-year RFS rates were 75 % and 44 % in the groups without the myxoid matrix and with the myxoid matrix, respectively.
Conclusion. The results of the study demonstrated that the presence of the myxoid matrix in WDLPS was associated with poor prognosis. We believe that the presence of the myxoid matrix in WDLPS can serve as an effective morphological marker of a less favorable prognosis for retroperitoneal WLPS .
About the Authors
A. Yu. VolkovRussian Federation
MD, Postgraduate, Surgical Oncology Department №6 (abdominal oncology)
23, Kashirskoe highway, 115478, Moscow, Russia
N. A. Kozlov
Russian Federation
MD, PhD, Pathology Department
23, Kashirskoe highway, 115478, Moscow, Russia
S. N. Nered
Russian Federation
MD, DSc, Leading Researcher, Surgical Oncology Department № 6 (abdominal oncology)
23, Kashirskoe highway, 115478, Moscow, Russia
I. S. Stilidi
Russian Federation
MD, Professor, Member of the Russian Academy of Sciences, Head of Surgical Oncology Department № 6 (abdominal oncology), Director
23, Kashirskoe highway, 115478, Moscow, RussiaA. M. Stroganova
Russian Federation
PhD, Head of the Molecular Genetic Laboratory of the Department of Morphological and Molecular Genetic
Diagnostics of Tumors
P. P. Arkhiri
Russian Federation
MD, PhD, Surgical Oncology Department № 6 (abdominal oncology)
23, Kashirskoe highway, 115478, Moscow, Russia
E. Yu. Antonova
Russian Federation
MD, Postgraduate, Department of Medicinal Treatment (Chemotherapy № 17 Department)
23, Kashirskoe highway, 115478, Moscow, Russia
S. A. Privezentsev
Russian Federation
MD, PhD, Deputy Chief Physician
32, 11th Parkovaya Street, 105077, Moscow, Russia
References
1. Kaprin A.D., Starinskiy V.V., Petrova G.V. The state of cancer care for the population of Russia in 2018. Moscow, 2019. 236. (in Russian).
2. Liles J.S., Tzeng C.W., Short J.J., Kulesza P., Heslin M.J. Retroperitoneal and intra-abdominal sarcoma. Curr Probl Surg. 2009 Jun; 46(6): 445–503. doi: 10.1067/j.cpsurg.2009.01.004.
3. Dalal K.M., Kattan M.W., Antonescu C.R., Brennan M.F., Singer S. Subtype specific prognostic nomogram for patients with primary liposarcoma of the retroperitoneum, extremity, or trunk. Ann Surg. 2006 Sep; 244(3): 381–91. doi: 10.1097/01.sla.0000234795.98607.00.
4. Fletcher C.D., Bridge J.A., Hogendoorn P., Mertens F. WHO Classification of Tumours of soft tissue and bone. 4th Ed. IARC. 2013; 3344.
5. Creytens D. What’s new in adipocytic neoplasia? Virchows Arch. 2020 Jan; 476(1): 29–39. doi: 10.1007/s00428-019-02652-3.
6. Vanhoenacker F.M., Parizel P.M., Gielen J.L. Imaging of Soft Tissue Tumors. 4th Ed 2017; 225230.
7. Goldblum J.R., Weiss S.W., Folpe A.L. Enzinger and Weiss’s soft tissue tumors. Philadelphia, PA: Elsevier. 2020; 1: 304.
8. Afanasyev S.G., Dobrodeev A.Yu., Volkov M.Yu. Surgical treatment outcomes of nonorganic retroperitoneal tumors. Siberian Journal of Oncology. 2015; 3: 51–54. (in Russian).
9. Canter R.J., Qin L.X., Ferrone C.R., Maki R.G., Singer S., Brennan M.F. Why do patients with low-grade soft tissue sarcoma die? Ann Surg Oncol. 2008 Dec; 15(12): 3550–60. doi: 10.1245/s10434-008-0163-0.
10. Thway K., Flora R., Shah C., Olmos D., Fisher C. Diagnostic utility of p16, CDK4, and MDM2 as an immunohistochemical panel in distinguishing well-differentiated and dedifferentiated liposarcomas from other adipocytic tumors. Am J Surg Pathol. 2012; 36(3): 462–9. doi: 10.1097/PAS.0b013e3182417330.
11. Dei Tos A.P., Doglioni C., Piccinin S., Sciot R., Furlanetto A., Boiocchi M., Dal Cin P., Maestro R., Fletcher C.D., Tallini G. Coordinated expression and amplification of the MDM2, CDK4, and HMGI-C genes in atypical lipomatous tumours. J Pathol. 2000 Apr; 190(5): 531–6. doi: 10.1002/(SICI)1096-9896(200004)190:5<531::AID-PATH579>3.0.CO;2-W.
12. Italiano A., Bianchini L., Keslair F., Bonnafous S., Cardot-Leccia N., Coindre J.M., Dumollard J.M., Hofman P., Leroux A., Mainguené C., Peyrottes I., Ranchere-Vince D., Terrier P., Tran A., Gual P., Pedeutour F. HMGA2 is the partner of MDM2 in well-differentiated and dedifferentiated liposarcomas whereas CDK4 belongs to a distinct inconsistent amplicon. Int J Cancer. 2008 May 15; 122(10): 223341. doi: 10.1002/ijc.23380.
13. Sirvent N., Coindre J.M., Maire G., Hostein I., Keslair F., Guillou L., Ranchere-Vince D., Terrier P., Pedeutour F. Detection of MDM2-CDK4 amplification by fluorescence in situ hybridization in 200 paraffinembedded tumor samples: utility in diagnosing adipocytic lesions and comparison with immunohistochemistry and real-time PCR. Am J Surg Pathol. 2007 Oct; 31(10): 1476–89. doi: 10.1097/PAS.0b013e3180581fff.
14. Tap W.D., Eilber F.C., Ginther C., Dry S.M., Reese N., BarzanSmith K., Chen H.W., Wu H., Eilber F.R., Slamon D.J., Anderson L. Evaluation of well-differentiated/de-differentiated liposarcomas by high-resolution oligonucleotide array-based comparative genomic hybridization. Genes Chromosomes Cancer. 2011 Feb; 50(2): 95–112. doi: 10.1002/gcc.20835.
15. Louis-Brennetot C., Coindre J.M., Ferreira C., Pérot G., Terrier P., Aurias A. The CDKN2A/CDKN2B/CDK4/CCND1 pathway is pivotal in well-differentiated and dedifferentiated liposarcoma oncogenesis: an analysis of 104 tumors. Genes Chromosomes Cancer. 2011 Nov; 50(11): 896–907. doi: 10.1002/gcc.20909.
16. Chrisinger J.S.A., Al-Zaid T., Keung E.Z., Leung C., Lin H.Y., Roland C.L., Torres K.E., Benjamin R.S., Ingram D.R., Khan S., Somaiah N., Amini B., Feig B.W., Lazar A.J., Wang W.L. The degree of sclerosis is associated with prognosis in well-differentiated liposarcoma of the retroperitoneum. J Surg Oncol. 2019 Sep; 120(3): 382–388. doi: 10.1002/jso.25585.
17. Weiss S.W., Rao V.K. Well-differentiated liposarcoma (atypical lipoma) of deep soft tissue of the extremities, retroperitoneum, and miscellaneous sites. A follow-up study of 92 cases with analysis of the incidence of «dedifferentiation». Am J Surg Pathol. 1992 Nov; 16(11): 1051–8. doi: 10.1097/00000478-199211000-00003.
18. Evans H.L. Atypical lipomatous tumor, its variants, and its combined forms: a study of 61 cases, with a minimum follow-up of 10 years. Am J Surg Pathol. 2007 Jan; 31(1): 1–14. doi: 10.1097/01.pas.0000213406.95440.7a.
Review
For citations:
Volkov A.Yu., Kozlov N.A., Nered S.N., Stilidi I.S., Stroganova A.M., Arkhiri P.P., Antonova E.Yu., Privezentsev S.A. THE PROGNOSTIC SIGNIFICANCE OF MYXOID MATRIX IN RETROPERITONEAL WELL-DIFFERENTIATED LIPOSARCOMA. Siberian journal of oncology. 2021;20(1):46-52. (In Russ.) https://doi.org/10.21294/1814-4861-2021-20-1-46-52