Evaluation of Prognostic Factors in Myxoid Liposarcoma Treated with Combined Neoadjuvant Radiotherapy and Surgical Excision: Systematic Review
Abstract
1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Inclusion Criteria
2.3. Data Collection
3. Results
3.1. Search Results
3.2. Demographic Data
3.3. Tumor Characteristics
3.4. Radiotherapy and Chemotherapy Treatment
3.5. Local Recurrence and Metastasis
3.6. Survival Rates
3.7. Prognostic Factors
3.7.1. Round Cells
3.7.2. Tumor Grade
3.7.3. Tumor Depth
3.7.4. Tumor Size
3.7.5. Marginal Status
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
MLPS | Myxoid Liposarcoma |
RT | Radiotherapy |
LR | Local Recurrence |
RCs | Round Cells |
References
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Author (Year) | Type of Study | LOE | N | Age | Sex | Site | Tumor Size | Grade | Tumor Depth | % Round Cell |
---|---|---|---|---|---|---|---|---|---|---|
Buyukceran et al. (2022) [17] | ROS | III | 43 | 56.3 | 32.5% F, 67.5% M | Upper limb (23.2%), Lower limb (76.7%) | 0–5 cm (18.6%) | Low (37.2%), High (62.7%) | N.R. | 0 (18.6%), 0–5 (53.5%) |
Chung et al. (2009) [10] | ROS | III | 88 | 48 | 41% F, 59% M | \ | \ | Grade 2 (93.2%), Grade 3 (6.8%) | Superficial (15%), Deep (85%) | \ |
Gronchi et al. (2019) [18] | POS | II | 14 | 36 | 50% F, 50% M | Tigh (71%), Leg (21%), Buttock (7%) | >10 cm (100%) | \ | Deep (100%) | \ |
Guadagnolo et al. (2008) [19] | ROS | III | 127 | 41 | 43% F, 57% M | Head and neck (2%), Superficial trunk (10%), Deep trunk (2%), Upper limb (3%), Lower limb (83%) | ≤5 (15%), >5 (85%), ≤10 (57%), >10 (43%) | \ | \ | \ |
Hoffman et al. (2013) [20] | ROS | III | 207 | 41 | 42.5% F, 57.5% M | Extremities (74%), Other (26%) | \ | \ | Deep (76%), Superficial (24%) | \ |
Lee et al. (2022) [21] | ROS | III | 24 | 39.9 | 75% F, 25% M | Thigh (91.7%), Calf (8.3%) | \ | \ | \ | Present (16.7%), Not present (75%), Unknown (8.3%) |
Houdek et al. (2023) [22] | ROS | III | 62 | 47 ± 14 | 45% F, 55% M | Lower extremity (97%), Upper extremity (3%) | \ | Low (81%), High (19%) | Deep (100%) | 0 (81%), 0–5 (16.1%), ≥5 (2.9%) |
Moreau et al. (2012) [23] | ROS | III | 418 | 45 | 41% F, 59% M | Lower limb (90%), Upper limb (7%), Chest wall (1%), Paraspinal (1%) | <5 cm (13.15%), 5–10 cm (33.25%), >10 cm (53.6%) | Grade 1 (33%), Grade 2 (49%), Grade 3 (14%), Unknown (4%) | Deep (81%), Superficial (18%) | Pure myxoid (74%), Round cell (26%) |
Perera et al. (2023) [24] | ROS | III | 198 | 46 | 34% F, 66% M | Lower extremity (97%), Upper extremity (3%) | \ | Grade 1 (16%), Grade 2 (62%), Grade 3 (19%) | \ | <5% (73%), ≥5% (15%) |
Salduz et al. (2017) [25] | ROS | III | 23 | 43 | 30.4% F, 69.6% M | Lower extremities (95.6%), Upper extremities (4.3%) | \ | \ | \ | Round cell (21.7%) |
Masunaga et al. (2023) [26] | ROS | III | 200 | <40 years (25%), 40–65 years (59%), >65 years (16%) | 38.5% F, 61.5% M | Lower limb (78%), Upper limb (5.5%), Trunk (16.5%) | <5 cm (4.5%), 5–10 cm (38%), 10–15 cm (30.5%), ≥15 cm (27%) | High (67%), Low (33%) | Deep (94%), Superficial (6%) | \ |
Lansu et al. (2021) [27] | POS | 79 | 45 | 44% F, 56% M | Lower extremity proximal (78%), Lower extremity distal (13%), Upper extremity (3%), Trunk (6%) | \ | \ | \ | <5% (77%), >5% (19%), Unknown (4%) |
Author (Year) | Tumor Dimension Pre- and Post-RT | RT Gy | RT | Chemotherapy | CT Protocols | Margins (%) |
---|---|---|---|---|---|---|
Buyukceran et al. (2022) [17] | \ | 45–50 Gy pre | Neo (32.5%) | 9.3% | doxorubicin + ifosfamide | R0 (41.9%) R1 (39.5%) R2 (18.6%) |
60 Gy post | Adj (67.4%) | |||||
Chung et al. (2009) [10] | \ | 50 Gy pre | Neo (47%), | \ | \ | R0 (81%) R1 (19%) |
60–66 Gy post | Adj (43%), Neo + boost postop (10%) | |||||
Gronchi et al. (2019) [18] | Size pre-RT: 12.5 cm | 45 Gy pre | Neo (100%) | 100% | trabectedin (median dose 2.6 mg per cycles) | R0 (58%) R1 (42%) |
16 Gy post (if R1) | ||||||
Guadagnolo et al. (2008) [19] | \ | 50 Gy pre | Neo (54%) | 28% | doxorubicin based + cyclophosphamide or vincristine or dacarbazine or ifosfamide | R0 (72%) R1-R2 (9%) Unknown (20%) |
60 Gy post | Adj (46%) | |||||
Hoffman et al. (2013) [20] | Size pre-RT: 10 ± 6.7 cm | \ | Neo 57%, Adj 42%, No surgery 1% | Neo (77%), Adj (17%) | doxorubicin + ifosfamide | R0 (83%), R1 (13%), R2 (4%) |
Lee et al. (2022) [21] | Size pre-RT: 12.4 cm; Volume pre-RT: 298.9 cm3; Size post-RT: 8.7 cm; Volume post-RT: 106.9 cm3 | 50 Gy pre | Neo (16.7%) | doxorubicin + ifosfamide | \ | |
Houdek et al. (2023) [22] | Size pre-RT 15 ± 6 cm; Volume pre-RT: 629 ± 631 cm3; Size post-RT: 12 ± 5 cm; Volume post-RT: 304 ± 387 cm3 | 50.4 Gy pre | Neo (55%), Neo + Boost intraop (34%), Neo + boost postop (11%) | 21% | doxorubicin + ifosfamide + mitomycin C and cisplatin | R0 (87%), R1 (3.2%), R2 (9.7%) |
Moreau et al. (2012) [23] | Size pre-RT 10 cm; Volume pre-RT 325 cm3 | 50 Gy pre | Neo (40.7%) | 6% | \ | R0 (73.9%) R1 (22%) R2 (3.3%) |
65 Gy post | Adj (28.2%) | |||||
66 Gy | Neo + Adj (5%) | |||||
Perera et al. (2023) [24] | Volume pre-RT: 240.6 cm3; post-RT volume change: 60.1% | 50 Gy pre | Neo (100%) | Micro positive (11%) <1 mm (15%) ≥1 mm (72%) | ||
Salduz et al. (2017) [25] | Size pre-RT: 13.7 cm | 28 Gy pre | Neo (100%) | Neo (34.8%) | adriamycin + ifosfamide (2 Cycles) | Wide (82.6%) Marginal (17.4%) |
Masunaga et al. (2023) [26] | \ | 30–56 Gy pre | Neo (50%) | 33.5%: Neo (31.4%), Adj (40.3%), Neo + Adj (28.3%) | anthracycline + ifosfamide; anthracycline | R0 (71.5%) R1 (24.5%) R2 (4%) |
45–70 Gy post | Adj (50%) | |||||
Lansu et al. (2021) [27] | Size pre-RT: 9.9 cm | 36 Gy pre | Neo (99%) | \ | \ | R0 (94%) R1 (6%) |
30 Gy post | Neo + Adj (1%) |
Author (Year) | Complications (%) | Follow-Up (m) | % LR | Time to LR (m) | LR-Free Survival | % METS | Time to METS (m) | METS-Free Survival | Disease-Free Survival | DSS | Overall Survival |
---|---|---|---|---|---|---|---|---|---|---|---|
Buyukceran et al. (2022) [17] | Wound necrosis (14%) | 106.8 | 27.9 | 22.8 | \ | 9.3 | \ | \ | \ | \ | 2 Y (93%) 5 Y (81.2%) 10 Y (72.7%) |
Chung et al. (2009) [10] | \ | 86 | 2.27 | \ | 5 Y (97.7%) | 13.6 | \ | 5 Y (89.1%) | \ | \ | 5 Y (93.9%) |
Gronchi et al. (2019) [18] | Sepsis (1%) | 26 | 7.14 | \ | 3 Y (92%) | 7.14 | 15 | \ | 3 Y (86%) | \ | 3 Y (93%) |
Guadagnolo et al. (2008) [19] | Edema (4%), Cellulitis (1%), Fibrosis (1.57%), Stress fracture (2.4%) | 109.2 | 3 | 14 | \ | 21 | 27 | 5 Y (85%) 10 Y (76%) | 5 Y (81%) 10 Y (73%) 15 Y (71%) | 5 Y (89%) 10 Y (83%) 15 Y (78%) | 5 Y (87%) 10 Y (79%) 15 Y (71%) |
Hoffman et al. (2013) [20] | \ | 68 | 7.4 | 31 | \ | 13 | 34 | \ | \ | 1 Y (99%) 5 Y (93%) 10 Y (87%) | \ |
Lee et al. (2022) [21] | Wound complications (25%) | \ | \ | \ | \ | \ | \ | \ | \ | \ | \ |
Houdek et al. (2023) [22] | Wound healing (21%), Radiation-associated fractures (13%), Deep infection (8%) | 96 | 6 | 35 | 2 Y (98%) 5 Y (93%) 10 Y (90%) | 29 | 20 | \ | 2 Y (81%) 5 Y (68%) 10 Y (66%) | 2 Y (94%) 5 Y (84%) 10 Y (76%) | \ |
Moreau et al. (2012) [23] | \ | 62.4 | 7 | 33 | 10 Y (93%) | 20 | 26.4 | \ | 5 Y (77%) | 5 Y (85%) | \ |
Perera et al. (2023) [24] | 18% | 60.7 | 1 | 17 | 5 Y (98.9%) | 24.24 | \ | 5 Y (77.2%) | \ | \ | 5 Y (94.2%) |
Salduz et al. (2017) [25] | \ | 55.1 | 4 | 52 | 5 Y (91%) 10 Y (91%) | 26 | 51 | \ | 5 Y (66%) 10 Y (66%) | \ | 5 Y (78.1%) 10 Y (71%) |
Masunaga et al. (2023) [26] | Wound complications (9.5%) | 40.5 | 6.5 (RT Neo) 9 (RT Adj) | 21 (RT Neo) 14 (RT Adj) | 5 Y (94.9%) | 15.5 | \ | \ | \ | 5 Y (88.1%) | \ |
Lansu et al. (2021) [27] | Wound complications (22%) | 25 | 0 | \ | \ | 2.5 | \ | \ | 1 Y (97%) 3 Y (93%) | 1 Y (99%) 3 Y (96%) | 1 Y (99%) 3 Y (95%) |
Prognostic Factors | Authors | |||
---|---|---|---|---|
Buyukceran et al. (2022) [17] | Moreau et al. (2012) [23] | Perera et al. (2023) [24] | Salduz et al. (2017) [25] | |
LRFS and depth | \ | \ | \ | \ |
LRFS and size | \ | \ | \ | \ |
LRFS and histology | \ | \ | \ | \ |
LRFS and margin | \ | 5 Y: R0 (95%), R1 (83%), R2 (43%) | 5 Y: microscopically positive (100%), R1 < 1 mm (96.4%), R1 > 1 mm (99.3%) | \ |
MT and size | \ | \ | \ | >15 cm (83%) [p = 0.006] |
MFS and margins | \ | \ | 5 Y: microscopically positive (67,5%), R1 < 1 mm (74,4%), R1 > 1 mm (79%) | Wide (higher MFS) [p = 0.023] |
MFS and grade | \ | 5 Y: grade 1 (90%), grade 2 (87%), grade 3 (67%) | \ | \ |
MFS and depth | \ | 5 Y: deep (78%), superficial (96%) | \ | \ |
MFS and histology | \ | 5 Y: >5% RC (84%), >25% (69%) | \ | 5 Y: RC (27%) [p = 0.052] |
DSS and histology | \ | \ | \ | |
OS and %RC | 2 Y: >5% (91.7%) 10 Y: >5% (50%) | \ | \ | 5 Y: RC (53%) |
OS and grade | 10 Y: low-grade (86.3%), high-grade (46.2%) | \ | \ | \ |
OS and surgical margin | 10 Y: R0 (94.4%), R1 (62.5%), R2 (33%) | \ | \ | \ |
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Papalia, G.F.; De Marco, G.; Luciano, C.; Sisca, L.; Farsetti, P.; Vincenzi, B.; Papalia, R. Evaluation of Prognostic Factors in Myxoid Liposarcoma Treated with Combined Neoadjuvant Radiotherapy and Surgical Excision: Systematic Review. Diseases 2025, 13, 177. https://doi.org/10.3390/diseases13060177
Papalia GF, De Marco G, Luciano C, Sisca L, Farsetti P, Vincenzi B, Papalia R. Evaluation of Prognostic Factors in Myxoid Liposarcoma Treated with Combined Neoadjuvant Radiotherapy and Surgical Excision: Systematic Review. Diseases. 2025; 13(6):177. https://doi.org/10.3390/diseases13060177
Chicago/Turabian StylePapalia, Giuseppe Francesco, Giulia De Marco, Claudia Luciano, Luisana Sisca, Pasquale Farsetti, Bruno Vincenzi, and Rocco Papalia. 2025. "Evaluation of Prognostic Factors in Myxoid Liposarcoma Treated with Combined Neoadjuvant Radiotherapy and Surgical Excision: Systematic Review" Diseases 13, no. 6: 177. https://doi.org/10.3390/diseases13060177
APA StylePapalia, G. F., De Marco, G., Luciano, C., Sisca, L., Farsetti, P., Vincenzi, B., & Papalia, R. (2025). Evaluation of Prognostic Factors in Myxoid Liposarcoma Treated with Combined Neoadjuvant Radiotherapy and Surgical Excision: Systematic Review. Diseases, 13(6), 177. https://doi.org/10.3390/diseases13060177