Michigan Journal of Medicine

Introduction

Myxoid liposarcoma is a malignant class of soft-tissue tumor that accounts for 12.8% of diagnosed soft-tissue cancers and 30-40% of diagnosed liposarcomas.^1,2 Despite making up a notable portion of soft-tissue malignancies, debate continues as to the optimal treatment modalities to manage myxoid liposarcomas.³ Our team aimed to chart the impact that common treatment modalities have on the metastasis-free rate for patients treated for myxoid liposarcoma at a large academic center. In doing so, we hope to provide treatment teams with crucial information that may inform the treatment choices they present patients.

Methods

A large academic tertiary care center’s sarcoma data archives were mined for cases of patients who were diagnosed with myxoid liposarcoma between January 1, 1997 and June 24, 2021. Inclusion criteria were that patients had histologically confirmed myxoid liposarcoma without evidence of metastasis at the time of diagnosis. The treatment modalities of interest were chemotherapy, radiotherapy, and combination chemoradiotherapy. Metastasis-free rates at 2, 5, 7, 10, 12, and 15 years after diagnosis were charted and the appropriate univariate statistical tests were applied to the data.

Results

66 patients were diagnosed with myxoid liposarcoma at the institution of interest and met inclusion criteria during the study period. Mean age at the time of diagnosis was 46 (standard deviation 13 years) and 36 (55%) of the patients were male. 36 (55%) patients received chemotherapy, and 60 (91%) received radiation therapy. 29 (44%) patients received monotherapy (only chemotherapy or radiation therapy), 32 (48%) underwent combined chemoradiotherapy, and 5 (8%) received neither chemotherapy or radiation. The receipt of chemotherapy or radiotherapy as monotherapy was associated with a statistically significant (p<0.05) higher metastasis-free rate at all timepoints after 2 years. Similarly, the receipt of combination chemoradiotherapy was associated with a statistically significant higher metastasis-free rate than monotherapy or no therapy at all at all timepoints after 2 years.

Conclusions

This work highlights the importance of utilizing multimodality treatments in the management of myxoid liposarcoma, when appropriate. Further work on this topic is required, but we hope these findings will enhance the decision-making algorithms of physicians treating this malignancy.

References

1. Soomers V, Husson O, Young R, et al. The sarcoma diagnostic interval: a systematic review on length, contributing factors and patient outcomes. ESMO Open. 2020 Feb;5(1):e000592. doi: 10.1136/esmoopen-2019-00059

2. Amer, Kamil M, et al. “Epidemiology and Survival of Liposarcoma and Its Subtypes: A Dual Database Analysis.” Journal of Clinical Orthopaedics and Trauma, vol. 11, 18 Apr. 2020, pp. S479–S484, https://doi.org/10.1016/j.jcot.2020.04.013.

3. Saifuddin A, Andrei V, Rajakulasingam R, et al. Magnetic resonance imaging of trunk and extremity myxoid liposarcoma: diagnosis, staging, and response to treatment. Skeletal Radiol. 2021 Oct;50(10):1963-1980. doi: 10.1007/s00256-021-03769-w.

Table 1: Patient Demographics, Tumor Characteristics, and Treatment Modalities with Metastasis-Free Rates