Liposarcoma: A clinicopathological study of 73 cases diagnosed at King Faisal Specialist Hospital and Research Centre

Liposarcoma is one of the most common adult soft tissue sarcomas, being second only to malignant fibrous histiocytoma. It ranges from the well-differentiated lipoma-like and myxoid tumors, to extremely cellular or pleomorphic malignant neoplasms. The clinical behavior is variable and reflects the variable microscopic picture.

Clinicopathological studies of liposarcoma in Saudi Arabia are lacking. In this study, we reviewed all liposarcoma cases reported at KFSH&RC from 1981 to 1996. Seventy-three cases of liposarcoma were studied morphologically. The cases were classified using the WHO International Classification of Diseases (ICD). Data regarding follow-up, mode of therapy, recurrence and survival status were available for 37 cases (50.68%). Survival analysis was performed. The patientsâ ages ranged from 15-94 years, with peak incidence between the ages 40 and 60 years. There was a male predominance of 1.3:1.

The most common location was the thigh (36 cases), accounting for 49.3% of cases, followed by the retroperitoneum (16 cases), accounting for 21.9%. The most common histologic type was myxoid liposarcoma (41 cases; 56.2%), followed by well-differentiated liposarcoma (16 cases; 21.9%), including dedifferentiated liposarcoma (5 cases; 6.8%), pleomorphic liposarcoma (13 cases; 17.8%) and round-cell liposarcoma (3 cases; 4.1%). Twenty-two patients (59.45%) were treated by surgery only, and 13 patients (35.13%) were treated by a combination of surgery and postoperative radiotherapy. One patient was treated by surgery, radiotherapy and chemotherapy, and died one month after diagnosis. Another patient was treated by radiotherapy alone and is still alive after a four-year follow-up period. The correlation between survival and recurrence with tumor type, location in regard to surgical accessibility, and mode of therapy, was not statistically significant.

Site, histologic type and completeness of surgical excision were the most important factors in predicting prognosis and planning therapy for patients with liposarcoma. The overall prognosis depends on many variable factors. Complete surgical excision reduces the recurrence rate. The role of chemotherapy and radiotherapy is not well established.