Abstract:
Objective To investigate the correlations between clinicopathological characteristics and prognosis for retroperitoneal liposarcoma to identify independent pathological indicators that affect prognosis.
Methods Pathological specimens from patients with retroperitoneal liposarcoma who underwent surgery at Beijing Shijitan Hospital, Capital Medical University from January 2008 to January 2018 were collected to examine histopathological features, including tumor size, histological types, lymphatic metastasis, vascular tumor emboli, and nerve invasion; immunohistochemical features, including Ki-67 and P53 proteins; and molecular pathological features such as MDM2 gene amplification.Clinical treatment and follow-up data were collected, and the survival rate was calculated using the Kaplan-Meier method. Univariate and multivariate survival analyses were performed to identify independent pathological factors.
Results Among 114 patients with retroperitoneal liposarcoma, 59 were males (51.8%) and 55 were females (48.2%), with a median age of 52(range, 22-80) years.Fortyeight (42.1%) patients had well-differentiated liposarcoma and 66(57.9%) had de-differentiated liposarcoma, with 2(1.4%) patients having lymph node metastases and 3(2.6%) having tumor emboli in the vessels.Eighty-eight (77.2%) patients had Ki-67 label index < 60% and 26 (22.8%) had Ki-67 label index ≥60%;furthermore, 85(74.6%) patients had P53 < 70% and 29(25.4%) had P53≥70%.Fluorescent in situ hybridization (FISH) study revealed MDM2 gene amplification.Univariate analysis revealed that the following pathological factors were correlated with prognosis:histopathological classification, FNCLLC grading, recurrence, mitosis, tumor necrosis, Ki-67 label index, and P53- positive ratio.Multivariate analysis using the Cox proportional hazard model revealed the following two independent pathological prognostic factors:tumor necrosis (HR=1.984, P=0.024) and recurrence (HR=2.161, P=0.049).
Conclusions Tumor necrosis and recurrence are independent pathological prognostic factors for retroperitoneal liposarcoma.