{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T09:19:02Z","timestamp":1754558342427,"version":"3.41.2"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T00:00:00Z","timestamp":1694131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81773135"],"award-info":[{"award-number":["81773135"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Retroperitoneal liposarcoma (RLS) is a rare but severe disease. Repeated postoperative recurrence with multiple tumors is a therapeutic dilemma. The clinical outcomes and survival predictors of recurrent RLS with multiple tumors remain to be explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with recurrent RLS were retrospectively analyzed. Univariate and multivariate analysis was performed to find independent prognostic factors that were correlated with Overall survival (OS) or progression-free survival (PFS). Factors significant in univariate analysis were further included into multivariate Cox proportional hazards regression model. The nomogram model was built to predict the survival status of patients. Variables that were significant in multivariable analysis were added to the internally validated nomogram models. The analysis of OS and PFS was performed by Kaplan\u2013Meier analysis and log-rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 113 recurrent RLS patients with multiple tumors were enrolled in the study. The 1-, 3-, and 5-years OS (PFS) rates were 70.7% (76.1%), 35.9% (76.1%), and 30.9% (76.1%), respectively. Univariate and multivariate analyses showed that number of surgeries, resection methods, tumor size, status of pathological differentiation, pathological subtypes, and recurrence patterns were important prognostic factors for OS or PFS (each <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05). Nomogram models were established to efficiently predict the prognostic status of patients. Patients with the local recurrence (LR) pattern had a poor prognosis and would derive no survival benefit from combined organ resection and R0\/R1 resection (each <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>RLS patients recurrence with multiple tumors had a poor prognosis. Those patients should be followed up more frequently after surgery. The strategies of aggressive resection may not improve the survival of patients with LR pattern in the retroperitoneum. Prognostic factors in the efficient nomogram models should be considered in the individualized clinical management of recurrent RLS with multiple tumors.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1161494","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T07:36:53Z","timestamp":1694158613000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Predictors and outcomes of recurrent retroperitoneal liposarcoma with multiple tumors"],"prefix":"10.3389","volume":"10","author":[{"given":"Huan","family":"Deng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingming","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingwang","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guibin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liqiang","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1016\/j.juro.2006.12.006","article-title":"Retroperitoneal liposarcoma","volume":"177","author":"Chouairy","year":"2007","journal-title":"J Urol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s10147-020-01796-6","article-title":"A novel nomogram for predicting local recurrence-free survival after surgical resection for retroperitoneal liposarcoma from a chinese tertiary cancer center","volume":"26","author":"Xue","year":"2021","journal-title":"Int J Clin Oncol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"6233","DOI":"10.2147\/OTT.S112580","article-title":"Current classification, treatment options, and new perspectives in the management of adipocytic sarcomas","volume":"9","author":"De Vita","year":"2016","journal-title":"Onco Targets Ther"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2136","DOI":"10.1245\/s10434-014-3643-4","article-title":"Locoregional disease patterns in well-differentiated and dedifferentiated retroperitoneal liposarcoma: implications for the extent of resection?","volume":"21","author":"Tseng","year":"2014","journal-title":"Ann Surg Oncol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1002\/jso.24427","article-title":"Preoperative radiation therapy combined with radical surgical resection is associated with a lower rate of local recurrence when treating unifocal, primary retroperitoneal liposarcoma","volume":"114","author":"Molina","year":"2016","journal-title":"J Surg Oncol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1002\/bjs.6994","article-title":"Surgical management of primary retroperitoneal sarcoma","volume":"97","author":"Strauss","year":"2010","journal-title":"Br J Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/1477-7819-9-12","article-title":"Retroperitoneal liposarcomas: the experience of a tertiary asian center","volume":"9","author":"Lee","year":"2011","journal-title":"World J Surg Oncol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1097\/SLA.0000000000001149","article-title":"Histology-based classification predicts pattern of recurrence and improves risk stratification in primary retroperitoneal sarcoma","volume":"263","author":"Tan","year":"2016","journal-title":"Ann Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1093\/annonc\/mdy052","article-title":"Management of metastatic retroperitoneal sarcoma: a consensus approach from the trans-Atlantic retroperitoneal sarcoma working group (tarpswg)","volume":"29","author":"Trans-Atlantic","year":"2018","journal-title":"Ann Oncol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1097\/PAT.0000000000000050","article-title":"Who classification of soft tissue tumours: an update based on the 2013 (4th) edition","volume":"46","author":"Jo","year":"2014","journal-title":"Pathology"},{"volume-title":"Classification of tumours editorial board. WHO classification of tumour soft tissue and bone tumours","year":"2022","key":"ref11"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1097\/SLA.0b013e3181b2468b","article-title":"Predicting outcome by growth rate of locally recurrent retroperitoneal liposarcoma","volume":"250","author":"Park","year":"2009","journal-title":"Ann Surg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/S1470-2045(19)30804-6","article-title":"CDK4\/6 inhibitor treatment for patients with hormone receptor-positive, HER2-negative, advanced or metastatic breast cancer: a US food and drug administration pooled analysis","volume":"21","author":"Jennifer","year":"2020","journal-title":"Lancet Oncol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"5665","DOI":"10.1097\/COC.0b013e31829b5667","article-title":"Retroperitoneal liposarcoma: a comprehensive review","volume":"12","author":"Adarsh","year":"2013","journal-title":"Am J Clin Oncol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.3390\/cancers14061362","article-title":"Targetable pathways in the treatment of retroperitoneal liposarcoma","volume":"14","author":"Casadei","year":"2022","journal-title":"Cancers (Basel)"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1097\/SLA.0b013e3181928f2f","article-title":"Multifocality in retroperitoneal sarcoma: a prognostic factor critical to surgical decision-making","volume":"249","author":"Anaya","year":"2009","journal-title":"Ann Surg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1002\/jso.24929","article-title":"Multiply recurrent retroperitoneal liposarcoma","volume":"117","author":"Bagaria","year":"2018","journal-title":"J Surg Oncol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.1093\/jjco\/hyaa126","article-title":"Characteristics of primary and repeated recurrent retroperitoneal liposarcoma: outcomes after aggressive surgeries at a single institution","volume":"50","author":"Ishii","year":"2020","journal-title":"Jpn J Clin Oncol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.jamcollsurg.2013.10.009","article-title":"Predictors of outcomes in patients with primary retroperitoneal dedifferentiated liposarcoma undergoing surgery","volume":"218","author":"Keung","year":"2014","journal-title":"J Am Coll Surg"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1097\/SLA.0000000000001447","article-title":"Variability in patterns of recurrence after resection of primary retroperitoneal sarcoma (rps)","volume":"263","author":"Gronchi","year":"2016","journal-title":"Ann Surg"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"6633","DOI":"10.2147\/CMAR.S321324","article-title":"Development and validation of a nomogram for predicting recurrence-free survival of surgical resected retroperitoneal liposarcoma","volume":"13","author":"Zhuang","year":"2021","journal-title":"Cancer Manag Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.1200\/JCO.2012.44.3747","article-title":"Outcome prediction in primary resected retroperitoneal soft tissue sarcoma: histology-specific overall survival and disease-free survival nomograms built on major sarcoma center data sets","volume":"31","author":"Gronchi","year":"2013","journal-title":"J Clin Oncol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"857827","DOI":"10.3389\/fonc.2022.857827","article-title":"Development and validation of a prognostic model to predict the prognosis of patients with retroperitoneal liposarcoma: a large international population-based cohort study","volume":"12","author":"Li","year":"2022","journal-title":"Front Oncol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1799","DOI":"10.3892\/ol.2017.7533","article-title":"A retrospective, single-center cohort study on 65 patients with primary retroperitoneal liposarcoma","volume":"15","author":"Yi-Xi","year":"2018","journal-title":"Oncol Lett"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1097\/PAS.0000000000000366","article-title":"Myogenic differentiation and histologic grading are major prognostic determinants in retroperitoneal liposarcoma","volume":"39","author":"Gronchi","year":"2015","journal-title":"Am J Surg Pathol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1053\/j.semdp.2019.02.006","article-title":"Well-differentiated liposarcoma and dedifferentiated liposarcoma: an updated review","volume":"36","author":"Thway","year":"2019","journal-title":"Semin Diagn Pathol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"424","DOI":"10.4103\/0973-1482.172590","article-title":"Mixed type retroperitoneal liposarcoma-combination of myxoid and well-differentiated type","volume":"12","author":"Pal","year":"2016","journal-title":"J Cancer Res Ther"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"102013","DOI":"10.1016\/j.ctrv.2020.102013","article-title":"A review of retroperitoneal liposarcoma genomics","volume":"86","author":"Tyler","year":"2020","journal-title":"Cancer Treat Rev"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"7854","DOI":"10.1245\/s10434-021-10024-y","article-title":"Analysis of differentiation changes and outcomes at time of first recurrence of retroperitoneal liposarcoma by transatlantic australasian retroperitoneal sarcoma working group (tarpswg)","volume":"28","author":"Nessim","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1097\/01.sla.0000086542.11899.38","article-title":"Histologic subtype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma","volume":"121","author":"Singer","year":"2003","journal-title":"Ann Surg"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1481","DOI":"10.1245\/s10434-010-1061-9","article-title":"Are radical compartmental resections for retroperitoneal sarcomas justified?","volume":"17","author":"Raut","year":"2010","journal-title":"Ann Surg Oncol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1007\/s00268-017-4157-6","article-title":"Radical nephrectomy for primary retroperitoneal liposarcoma near the kidney has a beneficial effect on disease-free survival","volume":"42","author":"Rhu","year":"2018","journal-title":"World J Surg"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1161494\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T07:36:56Z","timestamp":1694158616000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1161494\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,8]]},"references-count":32,"alternative-id":["10.3389\/fmed.2023.1161494"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1161494","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2023,9,8]]},"article-number":"1161494"}}