Retroperitoneal liposarcoma with colonic involvement: a case report

A systematic review of margin status in retroperitoneal liposarcomas: Does the R0 margin matter?

Retroperitoneal liposarcomas (RPLPSs) are a rare tumor group for which current guidelines recommend aggressive en bloc resection to attain microscopically negative (R0) margins. To ensure R0 margins, resection of adherent or adjacent organs is often required. However, it is still unclear if R0 margins confer any additional benefit to patients over a grossly negative but microscopically positive (R1) margin. We performed a systematic search of PubMed and Embase databases for studies including patients receiving R0 or R1 resection for RPLPS. Nine retrospective cohort studies, one prospective cohort study, and 49 case reports/case series were included. A total of 552 patients with RPLPS were evaluated: 346 underwent R0 resection and 206 underwent R1 resection. In the R0 group, 5-year overall survival (OS) ranged from 58.3% to 85.7%; local recurrence (LR) ranged from 45.5% to 52.3%. In the R1 group, 5-year OS ranged from 35% to 55.3%; LR ranged from 66.7% to 91.7%. Among cohort studies, OS, disease-free survival (DFS), LR rate, and LR-free survival (LRFS) were significantly associated with R0 resections. Assessment of case series and reports suggested that the R0 margin led to a slightly higher morbidity than that of R1. In conclusion, this review found the R0 margin to be associated with reductions in LR rates and improved OS when compared with the R1 margins, though accompanied by slight increases in morbidity. The roles of tumor histotype and perioperative chemotherapy or radiotherapy were not well-elucidated in this review.

Dedifferentiated Liposarcoma of the Descending Colon: A Case Report and Review of the Literature

Dedifferentiated liposarcomas are rare; localization of these tumors in the descending colon is extremely uncommon. We describe the case of a 75-year-old man with a dedifferentiated liposarcoma originating from the descending colon that manifested as partial bowel obstruction. The very uncommon presentation of this rare disease contributed to a challenging diagnostic process. The patient was successfully treated by surgical resection of the mass through left hemicolectomy. Although exceptionally unusual, soft tissue sarcomas should be considered in the differential diagnosis for bowel obstruction. Currently, radical resection of the mass is considered to be the first-line treatment.

Huge retroperitoneal liposarcoma with renal involvement requires nephrectomy: A case report and literature review

A 60-year-old female visited Guihang Guiyang Hospital (Guiyang, China). She presented with abdominal pain in the right side for the previous 2-months, with a touchable mass identified for the previous 1-month. Computed tomography with magnetic resonance imaging revealed a huge mass in the right abdomen. The diagnosis of well-differentiated retroperitoneal liposarcoma with renal involvement was made. During surgery, the tumor was removed, including the fatty renal capsule; however, the kidney was preserved. It is currently debatable whether resection of adjacent organs is required to obtain the negative margins. Conventional viewpoints advise that multi-organ resection is required in order to obtain the negative-margin. However, even if an R0 resection is achieved, the local recurrence rate remains markedly high. Additionally, the complications of organ resection have more impact on patients. Radiotherapy and chemotherapy are an important adjuvant method for these patients. In conclusion, retroperitoneal liposarcoma is a rare disease with a high rate of recurrence. Complete resection is the predominant treatment; however, combined resection of adjacent organs must be considered.