title: Is multimodality therapy necessary for the management of pure myxoid liposarcomas? A multi-institutional series of pure myxoid liposarcomas of the extremities and torso.
abstract: OBJECTIVE
  The treatment of patients with pure (<5% round cell component) myxoid liposarcomas (pMLS) has not been well characterized. We hypothesized that multimodality therapy (oncological resection with radiation therapy) may not be necessary for pMLS.
  
  
  METHODS
  Patients who underwent resection of localized pMLS at three institutions from 2000 to 2010 were identified and treatment variables were analyzed.
  
  
  RESULTS
  Of 75 pts with pMLS, the median tumor size was 10 cm, the majority (95%) were deep tumors, and located in lower extremity. Radiation (XRT) was administered to 58 pts(77%). Comparing the no XRT to XRT patients, lower extremity location (77% vs. 79%, P=1.0), tumor size (13 vs. 11 cm, P=0.3), and positive margins (13% vs. 16%, P=1.0) were similar. The majority (82%) of patients not receiving XRT had deep tumors. After a median follow-up of 60 months, 2 pts (3%) developed local recurrence and 10 pts (13%) developed distant recurrence with a mean recurrence-free survival (RFS) and disease-specific survival (DSS) of 114 and 148 mos, respectively. In multivariate analyses, increasing age and tumor size were the only significant predictors of recurrence. XRT was not a significant predictor of RFS in multivariate analysis.
  
  
  CONCLUSIONS
  pMLS is an STS subtype with favorable tumor biology and an extremely low-rate of local recurrence. Our results suggest that multimodality therapy may not be necessary for all pMLS.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Baxter
authors.forename: Nicholas
authors.initials: N
authors.lastname: Govsyeyev
authors.forename: Jukes P
authors.initials: JP
authors.lastname: Namm
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Gonzalez
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Roggin
authors.forename: Kenneth
authors.initials: K
authors.lastname: Cardona
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005121:Extremities / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018208:Liposarcoma, Myxoid / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D012042:Registries; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D060726:Torso / Q000601:surgery; D055815:Young Adult