title: Visceral Fat Content Correlates with Retroperitoneal Soft Tissue Sarcoma (STS) Local Recurrence and Survival.
abstract: BACKGROUND
  Our aim was to evaluate the association between visceral fat content with soft tissue sarcoma (STS) local recurrence and survival.
  
  
  METHODS
  One hundred and one computed tomography imaging studies of primary STS patients who had complete macroscopic resection at our institution between 2002 and 2012 were reviewed, and retroperitoneal and circumferential fat contents were measured. Correlations between imaging findings and clinical data were analyzed.
  
  
  RESULTS
  Fifty-seven STS tumors (56.4%) were retroperitoneal; of them, 65% were high grade, median size was 15 cm (range 3-49), and the most common histological subtype was high grade liposarcoma (31.6%). Median follow-up length for the entire cohort was 64 months (range 6-95). High visceral fat (VF) content≥15 versus <15 mm was identified as a risk factor for retroperitoneal STS local recurrence; 65.1 versus 26.7%, respectively (p=0.04); VF content did not correlate with distant metastasis. Median overall survival (OS) length of patients with VF≥15 versus <15 mm was 57 months (range 2-144) versus not reached, respectively (p=0.007). Multivariable analysis identified VF≥15 mm as an independent risk factor for decreased OS (HR: 4.2, 95% CI 1.07-16.67). In contrast, circumferential fat content did not correlate with retroperitoneal STS patient outcomes.
  
  
  CONCLUSIONS
  High VF content is an independent adverse prognosticator associated with significantly higher rates of retroperitoneal STS local recurrence and decreased patients survival. Local tumor biology may be affected by the presence of adipose cells. Further clinical and molecular research is needed to establish this premise.
authors: Department of Surgery, The Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, 6 Weitzman St., Tel-Aviv, Israel, michail.a.papoulas@gmail.com.
authors: Michail
authors: M
authors: Papoulas
authors: Roi
authors: R
authors: Weiser
authors: Galia
authors: G
authors: Rosen
authors: Fabian
authors: F
authors: Gerstenhaber
authors: Ofer
authors: O
authors: Merimsky
authors: Nir
authors: N
authors: Lubezky
authors: Joseph M
authors: JM
authors: Klausner
authors: Guy
authors: G
authors: Lahat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology*; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D012509:Sarcoma / Q000401:mortality*; D055815:Young Adult