{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:47:28Z","timestamp":1793119648690,"version":"4.5.0"},"reference-count":36,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>(1) Background: Histological diagnosis and tumor grading are major prognostic and predictive factors in soft tissue sarcomas (STS), as they dictate the treatment strategies with a direct impact on patient survival. This study aims to investigate the grading accuracy, sensitivity, and specificity of Tru-Cut\u00ae biopsy (TCB) in primary localized myxoid liposarcomas (MLs) of the extremities and its impact on patient prognosis. (2) Methods: Patients with ML undergoing TCB and a subsequent tumor resection between 2007 and 2021 were evaluated. Concordance between the preoperative assessment and definitive histology was calculated with a weighted Cohen\u2019s kappa coefficient. Sensitivity, specificity, and diagnostic accuracy were calculated. (3) Results: Of 144 biopsies, the histological grade concordance rate was 63% (Kappa 0.2819). Neoadjuvant chemotherapy and\/or radiotherapy impacted concordance with a downgrading effect in high-grade tumors. Among forty patients not treated in neoadjuvant settings, the sensitivity of TCB was 57%, the specificity was 100%, and the overall predictive values of positive and negative TCB were 100% and 50%, respectively. Misdiagnosis did not impact overall survival. (4) Conclusions: TCB may underestimate ML grading due to tumor heterogeneity. Neoadjuvant ChT and\/or radiotherapy are associated with pathological downgrading; however, discordance in diagnosis does not modify patient prognosis because systemic treatment decision-making also includes other variables.<\/jats:p>","DOI":"10.3390\/cancers15051391","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T01:31:06Z","timestamp":1677115866000},"page":"1391","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Sensitivity, Specificity, and Predictive Values of Tru-Cut\u00ae Biopsy in Grading Primary Localized Myxoid Liposarcomas of the Extremities"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6390-9762","authenticated-orcid":false,"given":"Giuseppe","family":"Bianchi","sequence":"first","affiliation":[{"name":"3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4021-9694","authenticated-orcid":false,"given":"Roberta","family":"Laranga","sequence":"additional","affiliation":[{"name":"3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Spinnato","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Ostetto","sequence":"additional","affiliation":[{"name":"3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Bubbico","sequence":"additional","affiliation":[{"name":"3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1074-0155","authenticated-orcid":false,"given":"Alberto","family":"Righi","sequence":"additional","affiliation":[{"name":"Anatomy and Pathological Histology, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1\/10, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide Maria","family":"Donati","sequence":"additional","affiliation":[{"name":"3rd Orthopaedic and Traumatologic Clinic Prevalently Oncologic, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40123 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/S0035-1040(06)75924-4","article-title":"Diagnosis and treatment of soft-tissue tumors","volume":"92","author":"Dujardin","year":"2006","journal-title":"Rev. Chir. Orthop. Reparatrice Appar. Mot."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1097\/PAS.0b013e3181963c9c","article-title":"Liposarcomas in Young Patients: A Study of 82 Cases Occurring in Patients Younger than 22 Years of Age","volume":"33","author":"Alaggio","year":"2009","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_3","first-page":"1450","article-title":"The Clinicopathologic Spectrum of Myxoid and Round Cell Liposarcoma A Study of 95 Cases","volume":"77","author":"Kilpatrick","year":"1996","journal-title":"Cancer Interdiscip. Int. J. Am. Cancer Soc."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Tuzzato, G., Laranga, R., Ostetto, F., Bubbico, E., Vara, G., and Bianchi, G. (2022). Primary High-Grade Myxoid Liposarcoma of the Extremities: Prognostic Factors and Metastatic Pattern. Cancers, 14.","DOI":"10.3390\/cancers14112657"},{"key":"ref_5","first-page":"8928706","article-title":"Myxoid Liposarcoma: Prognostic Factors and Metastatic Pattern in a Series of 148 Patients Treated at a Single Institution","volume":"2018","author":"Muratori","year":"2018","journal-title":"Int. J. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Lansu, J., Van Houdt, W.J., Schaapveld, M., Walraven, I., Van De Sande, M.A.J., Ho, V.K.Y., and Haas, R.L. (2020). Time Trends and Prognostic Factors for Overall Survival in Myxoid Liposarcomas: A Population-Based Study. Sarcoma, 437850.","DOI":"10.1155\/2020\/2437850"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2522","DOI":"10.1002\/cncr.22720","article-title":"Myxoid\/round cell and pleomorphic liposarcomas: Prognostic factors and survival in a series of patients treated at a single institution","volume":"109","author":"Fiore","year":"2007","journal-title":"Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.1002\/cncr.27847","article-title":"Localized and Metastatic Myxoid\/Round Cell Liposarcoma Clinical and Molecular Observations","volume":"119","author":"Hoffman","year":"2013","journal-title":"Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6015","DOI":"10.1038\/sj.onc.1204018","article-title":"Liposarcoma initiated by FUS\/TLS-CHOP: The FUS\/TLS domain plays a critical role in the pathogenesis of liposarcoma","volume":"19","author":"Pintado","year":"2000","journal-title":"Oncogene"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/00000478-199602000-00005","article-title":"Myxoid\/round cell liposarcoma of the extremities. A clinicopathologic study of 29 cases with particular attention to extent of round cell liposarcoma","volume":"20","author":"Smith","year":"1996","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1016\/j.annonc.2021.07.006","article-title":"Soft tissue and visceral sarcomas: ESMO\u2013EURACAN\u2013GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up\u2606","volume":"32","author":"Gronchi","year":"2021","journal-title":"Ann. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/00125480-199703000-00005","article-title":"Will We Ever Reliably Predict Prognosis in a Patient with Myxoid and Round Cell Liposarcoma?","volume":"4","author":"Fletcher","year":"1997","journal-title":"Adv. Anat. Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3041","DOI":"10.1007\/s11999-010-1396-3","article-title":"Clinicopathologic prognostic factors of pure myxoid liposarcoma of the extremities and trunk wall","volume":"468","author":"Nishida","year":"2010","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_14","first-page":"3977","article-title":"Prognostic impact of P53 status, TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma: A molecular and clinicopathologic study of 82 cases","volume":"7","author":"Antonescu","year":"2001","journal-title":"Clin. Cancer Res."},{"key":"ref_15","first-page":"472","article-title":"WHO Classification of Tumors 5th edition Soft Tissue and Bone Tumors","volume":"3","author":"Siegal","year":"2020","journal-title":"Adv. Anat. Pathol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"D\u00fcrr, H.R., Rauh, J., Baur-Melnyk, A., Kn\u00f6sel, T., Lindner, L., Roeder, F., Jansson, V., and Klein, A. (2018). Myxoid liposarcoma: Local relapse and metastatic pattern in 43 patients. BMC Cancer, 18.","DOI":"10.1186\/s12885-018-4226-8"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"iii113","DOI":"10.1093\/annonc\/mdu256","article-title":"Bone sarcomas: ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"25","author":"Casali","year":"2014","journal-title":"Ann. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"295","DOI":"10.5152\/imj.2018.78889","article-title":"Diagnostic Accuracy of Tru-Cut Biopsy for Soft Tissue Tumors","volume":"19","author":"Tetikkurt","year":"2018","journal-title":"Istanb. Med. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2774","DOI":"10.1007\/s11999-010-1422-5","article-title":"Office-based core needle biopsy of bone and soft tissue malignancies: An accurate alternative to open biopsy with infrequent complications","volume":"468","author":"Adams","year":"2010","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"656","DOI":"10.2106\/00004623-199605000-00004","article-title":"The hazards of the biopsy, revisited: For the members of the musculoskeletal tumor society","volume":"78","author":"Mankin","year":"1996","journal-title":"J. Bone Jt. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"644","DOI":"10.2106\/00004623-199605000-00002","article-title":"Diagnostic Accuracy and Charge-Savings of Outpatient Core Needle Biopsy Compared with Open Biopsy of Musculoskeletal Tumors","volume":"78","author":"Skrzynski","year":"1996","journal-title":"J. Bone Jt. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/2047-783X-17-29","article-title":"Percutaneous core needle biopsy versus open biopsy in diagnostics of bone and soft tissue sarcoma: A retrospective study","volume":"17","author":"Pohlig","year":"2012","journal-title":"Eur. J. Med. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1177\/230949901302100123","article-title":"Accuracy of core needle biopsy for musculoskeletal tumours","volume":"21","author":"Seng","year":"2013","journal-title":"J. Orthop. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/j.jos.2018.06.008","article-title":"Liposarcoma: Clinico-pathological analysis, prognostic factors and survival in a series of 307 patients treated at a single institution","volume":"23","author":"Muratori","year":"2018","journal-title":"J. Orthop. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Enneking, W.F., Dunham, W., Gebhardt, M.C., Malawar, M., and Pritchard, D.J. (1993). A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin. Orthop. Relat. Res., 241\u2013246.","DOI":"10.1097\/00003086-199301000-00035"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2992","DOI":"10.1007\/s11999-010-1401-x","article-title":"A comparison of fine-needle aspiration, core biopsy, and surgical biopsy in the diagnosis of extremity soft tissue masses","volume":"468","author":"Kasraeian","year":"2010","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1080\/13577149877911","article-title":"Fine-needle aspiration cytology of soft tissue sarcom a: Bene\u00ae ts and limitations","volume":"2","author":"Kerm","year":"1998","journal-title":"Sarcoma"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1053\/adpa.2000.8133","article-title":"Liposarcoma: New entities and evolving concepts","volume":"4","year":"2000","journal-title":"Ann. Diagn. Pathol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/s10434-001-0080-y","article-title":"Accuracy of Biopsy Techniques for Limb and Limb Girdle Soft Tissue Tumors","volume":"8","author":"Hoeber","year":"2001","journal-title":"Ann. Surg. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2677","DOI":"10.1002\/1097-0142(20001215)89:12<2677::AID-CNCR22>3.0.CO;2-L","article-title":"The percutaneous needle biopsy is safe and recommended in the diagnosis of musculoskeletal masses","volume":"89","author":"Welker","year":"2000","journal-title":"Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1002\/cncr.21154","article-title":"Core-Needle Biopsy Performed by the Cytopathologist A Technique to Complement Fine-Needle Aspiration of Soft Tissue and Bone Lesions","volume":"105","author":"Domanski","year":"2005","journal-title":"Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/00003086-199911000-00026","article-title":"Biopsy of musculoskeletal tumors. Current concepts","volume":"368","author":"Bickels","year":"1999","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"963","DOI":"10.2214\/AJR.19.22147","article-title":"Soft Tissue Sarcoma: Preoperative MRI-Based Radiomics and Machine Learning May Be Accurate Predictors of Histopathologic Grade","volume":"215","author":"Xu","year":"2020","journal-title":"Am. J. Roentgenol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1055\/s-0030-1261786","article-title":"Image-guided percutaneous ablation of bone and soft tissue tumors","volume":"27","author":"Kurup","year":"2010","journal-title":"Semin. Interv. Radiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1002\/cncr.32735","article-title":"Core Needle Biopsy Versus Incisional Biopsy for Differentiation of Soft-Tissue Sarcomas: A Systematic Review and Meta-Analysis","volume":"126","author":"Birgin","year":"2020","journal-title":"Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1038\/s41598-022-05752-4","article-title":"Accuracy of core needle biopsy for histologic diagnosis of soft tissue sarcoma","volume":"12","author":"Kiefer","year":"1886","journal-title":"Sci. Rep."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/5\/1391\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:39:35Z","timestamp":1760121575000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/5\/1391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,22]]},"references-count":36,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["cancers15051391"],"URL":"https:\/\/doi.org\/10.3390\/cancers15051391","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,22]]}}}