caa a22 4500 445338776 CHVBK 20180317142805.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1794-0 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1794-0 Diagnosis, Management, and Outcome of Patients with Dedifferentiated Liposarcoma Systemic Metastasis [Elektronische Daten] [Markus Ghadimi, Tariq Al-Zaid, John Madewell, Tingsheng Peng, Chiara Colombo, Aviad Hoffman, Chad Creighton, Yiqun Zhang, Anna Zhang, Alexander Lazar, Raphael Pollock, Dina Lev] Background: Dedifferentiated liposarcomas (DDLPSs) result in worse patient outcomes than well-differentiated tumors despite shared molecular derangements. Prevalence and pattern of DDLPS systemic metastases have not been extensively reported; information regarding diagnosis, treatment, and outcomes of metastatic DDLPS patients is limited. Our study seeks to address this knowledge gap. Methods: Metastatic patients were identified from a clinical database consisting of 277 DDLPS patients treated at the University of Texas M D Anderson Cancer Center (UTMDACC) (1993-2010). Only patients with radiologically demonstrable distant metastases were included. Patient, tumor, treatment, and outcome variables were recorded. Available imaging studies and tumor FFPE blocks were assessed. Results: A total of 40 patients were identified, translating into a DDLPS metastatic rate of 14% (17% for de novo DDLPS and 9% for secondary dedifferentiation). The average patient age was 61years with a male predilection. The retroperitoneum and lungs were the most common primary and metastatic tumor sites. Any of the 4 described DDLPS morphological subtypes harbored metastatic potential; MFH/UPS-like morphology was the most common. The median time from primary diagnosis to metastasis was 25months; more than 50% of metastases developed without local failure. The median survival of metastatic patients was 11.5months; the 5-year DSS was 5.2%. Patients amenable to complete surgical extirpation (n=14) faired significantly better (P=.001; log rank). Conclusions: Metastatic spread is an ominous consequence of DDLPS, especially regarding de novo tumors. Occurring relatively early in the course of disease and exhibiting a pulmonary predilection, these lesions are highly aggressive and commonly fatal. Further studies to identify metastatic biomarkers are needed. Society of Surgical Oncology, 2011 Ghadimi Markus Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Al-Zaid Tariq Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Madewell John Department of Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Peng Tingsheng Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Colombo Chiara Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Hoffman Aviad Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Creighton Chad Division of Biostatistics, Dan L. Duncan Cancer Center, Baylor College, Houston, TX, USA aut Zhang Yiqun Division of Biostatistics, Dan L. Duncan Cancer Center, Baylor College, Houston, TX, USA aut Zhang Anna Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Lazar Alexander The Sarcoma Research Center, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Pollock Raphael Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Lev Dina The Sarcoma Research Center, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3762-3770 1068-9265 18:13<3762 2011 18 10434 https://doi.org/10.1245/s10434-011-1794-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1794-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ghadimi Markus Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Al-Zaid Tariq Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Madewell John Department of Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Peng Tingsheng Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Colombo Chiara Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Hoffman Aviad Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Creighton Chad Division of Biostatistics, Dan L. Duncan Cancer Center, Baylor College, Houston, TX, USA aut NATIONALLICENCE 700 1- Zhang Yiqun Division of Biostatistics, Dan L. Duncan Cancer Center, Baylor College, Houston, TX, USA aut NATIONALLICENCE 700 1- Zhang Anna Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Lazar Alexander The Sarcoma Research Center, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Pollock Raphael Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 700 1- Lev Dina The Sarcoma Research Center, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3762-3770 1068-9265 18:13<3762 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer