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Myxoid\Round Cell Liposarcoma (MRCLS) Revisited: An Analysis of 418 Primarily Managed Cases

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Objectives of this study were to evaluate oncologic outcomes and to provide guidelines for the management of primary myxoid (MLS) and round cell liposarcoma (RCLS).

Methods

A multicenter, retrospective study of 418 cases of MRCLS primarily managed by Canadian multidisciplinary sarcoma teams.

Results

Study included 418 cases (MLS: 311 patients and RCLS: 107; > 5% round cell) with a median age of 45 years and a median follow-up of 5.2 years. Median tumor size was 10 cm, and 81% were deep and 90% were in lower limb. The majority of patients underwent surgical resection and radiotherapy, with a small percentage (6%) receiving chemotherapy. The overall 10-year local control rate was 93% with no differences between MLS and RCLS. Radiotherapy was significant in preventing local relapse and reducing tumor diameter (median = 18%) and improving microscopic margin status, but did not impact survival. Radiotherapy and the margin status were independent predictors of local recurrence. The 5- and 10-year metastatic-free survivals were 84 and 77% respectively for MLS and 69 and 46% for RCLS. The initial site of metastasis was found in multiple locations (34%) and bone involvement was frequent (40%) with predilection for spine (79%). Round cell percent (> 5%) and tumor diameter (> 10 cm) correlated with increased risk for metastasis and death.

Conclusions

MLS and RCLS showed different metastatic risk but equally good local control. Radiotherapy was effective in preventing local recurrence and should be delivered as neoadjuvant. New staging strategies are to be defined to account for the unusual metastatic pattern.

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Acknowledgment

Janie Barry, Anthony Griffin, Pascale Lévesque, Amy Phillips, Soha Riad, Abdul Rahman Neffati, Cindy Wong, Ayoub Nahal, Xun Zhang, Patrick Williams. This work was made possible through the generous funding of a summer research bursary from the Mach-Gaensslen Foundation of Canada.

Disclosure

The Mach-Gaensslen Foundation of Canada provided a summer research bursary to Mr L-C Moreau for this work. Stryker Orthopaedics Canada has provided institutional research support to the Department of Orthopaedic Surgery of the McGill University Health Centre. There are no other conflicts of interest to disclose.

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Authors and Affiliations

  1. Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada

    Louis-Charles Moreau & Robert Turcotte

  2. Orthopaedic Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada

    Peter Ferguson & Jay Wunder

  3. Orthopaedic Surgery, Princess Margaret Hospital, Toronto, Ontario, Canada

    Peter Ferguson & Jay Wunder

  4. Orthopaedics, University of British Columbia, Vancouver, Canada

    Paul Clarkson

  5. Surgical Oncology, British Columbia Cancer Agency, Vancouver, Canada

    Paul Clarkson

  6. Orthopaedic Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada

    Bas Masri

  7. Orthopaedic Surgery, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada

    Marc Isler

  8. Orthopaedic Surgery, Hôtel-Dieu, Quebec City, Quebec, Canada

    Norbert Dion

  9. Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada

    Joel Werier

  10. Orthopaedic Surgery, Juravinski Cancer Centre, Hamilton, Ontario, Canada

    Michelle Ghert & Benjamin Deheshi

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  1. Louis-Charles Moreau
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the Canadian Orthopaedic Oncology Society (CANOOS)

Corresponding author

Correspondence to Robert Turcotte.

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Moreau, LC., Turcotte, R., Ferguson, P. et al. Myxoid\Round Cell Liposarcoma (MRCLS) Revisited: An Analysis of 418 Primarily Managed Cases. Ann Surg Oncol 19, 1081–1088 (2012). https://doi.org/10.1245/s10434-011-2127-z

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  • DOI: https://doi.org/10.1245/s10434-011-2127-z

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