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Deep Introspection Regarding Cumulative Prognostic Factors in Liposarcoma and Atypical Lipomatous Tumor
Ana-Maria Ciongariu1, Șerban-Ștefan Radu2, Adrian-Vasile Dumitru1
1Department of Pathology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 030167 Bucharest, Romania.
Medicina (Kaunas, Lithuania)
|August 28, 2025
Summary
Prognostic evaluation of liposarcoma is improved by assessing tumor grade and proliferation using the LEMON score. This risk stratification helps distinguish low-risk from high-risk liposarcoma cases for better patient management.
Area of Science:
- Oncology
- Pathology
- Surgical Oncology
Background:
- Liposarcoma and atypical lipomatous tumor prognosis is complex due to tumor heterogeneity.
- Current guidelines recommend histological grade, focusing on mitotic activity and necrosis.
- Histological subtype significantly impacts liposarcoma progression and survival.
Purpose of the Study:
- To analyze overall survival in liposarcoma patients stratified by histological grade using Kaplan-Meier analysis.
- To evaluate the clinical utility of the LEMON score for risk stratification.
- To differentiate indolent (low-risk) from aggressive (high-risk) liposarcomas.
Main Methods:
- Retrospective multicenter study of 99 primary liposarcoma patients (2009-2023).
- Kaplan-Meier analysis for overall survival assessment.
- Comparison of Ki67 immunostaining sensitivity versus conventional mitotic count using Bland-Altman analysis.
Main Results:
- Higher histological grade (G1 vs. G3) significantly correlated with worse survival.
- Ki67 immunostaining demonstrated higher sensitivity for detecting cellular proliferation than mitotic counts.
- Risk stratification using tumor grade and LEMON score effectively segregated low-risk from high-risk liposarcomas.
Conclusions:
- Histopathological factors (subtype, mitotic index, necrosis) are crucial for liposarcoma prognosis.
- Tumor grade and proliferation activity evaluation are key for risk assessment.
- A two-tiered LEMON score system aids in identifying patients for intensified surveillance or therapy.
