title: Myxoid/round cell and pleomorphic liposarcomas: prognostic factors and survival in a series of patients treated at a single institution.
abstract: BACKGROUND
  The objective of this study was to investigate prognostic factors and clinical outcome of myxoid/round cell and pleomorphic liposarcoma.
  
  
  METHODS
  Three hundred twenty-nine patients with localized myxoid/round cell or pleomorphic liposarcoma who underwent surgery at the Istituto Nazionale per lo Studio e la Cura dei Tumori (Milan, Italy) over 25 years were reviewed. The rates of local recurrence, distant metastases, and survival were studied.
  
  
  RESULTS
  Two hundred fourteen patients presented with primary disease, and 115 patients had locally recurrent tumors. The disease-specific survival rate was 75% at 10 years, and the local recurrence and distant metastases incidence were 25% and 15%, respectively. Presentation with recurrent disease, tumor size (>10 cm), tumor grade (French Federation of Cancer Centers grade II or III vs grade I), and positive surgical margins were independent predictors of death. Tumor site and radiation therapy also played a role, mostly related to their effect on local outcome. Pathologic grade and histologic subtype influenced distant metastases. Extrapulmonary metastases were associated with poorer postmetastatic disease-specific survival.
  
  
  CONCLUSIONS
  Myxoid/round cell liposarcomas shared similar prognostic factors with other soft tissue sarcomas and had a relatively good clinical outcome. The presence of >5% of round cell component singled out a group of patients at greater risk of metastases and death but with a broad spectrum of disease aggressiveness. Extrapulmonary metastases were a peculiar pattern of myxoid/round cell liposarcoma that require special consideration for treatment and prognosis.
authors.affiliation: Department of Surgery, National Cancer Institute, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Fiore
authors.forename: Federica
authors.initials: F
authors.lastname: Grosso
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lo Vullo
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pennacchioli
authors.forename: Silvia
authors.initials: S
authors.lastname: Stacchiotti
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrari
authors.forename: Paola
authors.initials: P
authors.lastname: Collini
authors.forename: Laura
authors.initials: L
authors.lastname: Lozza
authors.forename: Luigi
authors.initials: L
authors.lastname: Mariani
authors.forename: Paolo G
authors.initials: PG
authors.lastname: Casali
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gronchi
mesh_terms: D000328:Adult; D018288:Carcinoma, Small Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008080:Liposarcoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018208:Liposarcoma, Myxoid / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome