title: Accuracy of preoperative percutaneous biopsy for the diagnosis of retroperitoneal liposarcoma subtypes.
abstract: BACKGROUND
  Surgery is the primary treatment for all subtypes of retroperitoneal liposarcoma, but neoadjuvant therapy may be warranted in cases of dedifferentiated liposarcoma (DDLS), which has an increased risk of recurrence and metastasis. Therefore, an accurate subtype-specific diagnosis is vital for appropriate consideration of neoadjuvant therapy. Previous studies assessing the subtype-specific accuracy of percutaneous biopsy are limited. We aimed to analyze the accuracy of preoperative percutaneous biopsy in the subtype-specific diagnosis of retroperitoneal liposarcoma and thus the reliability of percutaneous biopsy in guiding decisions about neoadjuvant treatment.
  
  
  METHODS
  We retrospectively reviewed the medical records, including the pathologic reports, interventional radiology reports, and operative reports, of patients registered in the retroperitoneal/well-differentiated liposarcoma (WDLS/DDLS) database at The University of Texas MD Anderson Cancer Center between 1993 and 2013.
  
  
  RESULTS
  We identified 120 patients who underwent 137 preoperative percutaneous biopsies followed by surgical resections. Pathologic examination following resection indicated that 74 of the patients had WDLS and 63 had DDLS. The overall diagnostic accuracy of percutaneous biopsy for identifying the subtype of liposarcoma was 62.8 % (86/137); the accuracy for identifying WDLS was significantly higher (85.1 %; 63/74) than that for identifying DDLS (36.5 %; 23/63) (p < 0.01).
  
  
  CONCLUSIONS
  Percutaneous biopsy has low accuracy in the diagnosis of retroperitoneal DDLS. This can potentially mislead physicians in the decision to implement neoadjuvant treatment. When developing treatment strategies, including clinical trials for patients with retroperitoneal liposarcoma, physicians should carefully consider the low accuracy of percutaneous biopsy in detecting DDLS.
authors.affiliation: Department of Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Ikoma
authors.forename: Keila E
authors.initials: KE
authors.lastname: Torres
authors.forename: Neeta
authors.initials: N
authors.lastname: Somaiah
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Hunt
authors.forename: Janice N
authors.initials: JN
authors.lastname: Cormier
authors.forename: William
authors.initials: W
authors.lastname: Tseng
authors.forename: Dina
authors.initials: D
authors.lastname: Lev
authors.forename: Raphael
authors.initials: R
authors.lastname: Pollock
authors.forename: Wei Lien
authors.initials: WL
authors.lastname: Wang
authors.forename: Barry
authors.initials: B
authors.lastname: Feig
mesh_terms: D001706:Biopsy; D002454:Cell Differentiation; D005500:Follow-Up Studies; D006801:Humans; D008080:Liposarcoma / Q000145:classification* / Q000175:diagnosis* / Q000601:surgery; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D015203:Reproducibility of Results; D012186:Retroperitoneal Neoplasms / Q000145:classification* / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity