Abstract
Neglected liposarcoma with late admission and huge tumour causes difficulties regarding surgical removal, obtaining tumour free margin and increased risk of local recurrence. Preoperative irradiation enables the surgeon to remove such tumours with ease of manipulation during surgery by maturation of the pseudocapsule with a decrease in local recurrence. Twenty-one patients with liposarcoma , 8 females, 13 males with a mean age of 49 (16–74) were treated by preoperative 5000 cGy irradiation and wide excision by the same surgeon between 1991–2004. Localization were 14 proximal thigh, 3 popliteal space, 3 gluteal region, 1 upper arm. Mean tumour volume was 550cc. Mean follow up was 37 months (6–144 mo.s). All patients were operated after 30 days of irradiation, 3 patients had arterial by pass and 1 patient had free latissimus dorsi flap reconstruction.
Oncological results: 3 DOD, 18 NED. 4 patients developed lung metastasis, 1 of them with local recurrence, the other 3 had no local recurrence, all 3 of them had myxoid liposarcoma with round cell component. They had second primaries in the retroperitoneal space also. The only patient in the series with local recurrence was succesfully treated by wide excision and femoral artery by pass and metastasectomy. Local complications were 4 fibrosis, 1 severe, 3 moderate and 1 local recurrence. No deep infection occured. Two patients had delayed wound healing that healed by meticulous wound care. Preoperative irradiation and wide excision with low local recurrence rate (%4.6) and with low morbidity regarding wound healing could be standard treatment for high grade liposarcoma. %9.5 severe fibrosis caused severe cosmetic problems but patients with fibrosis still had a functional salvaged limb with the help of single a cane.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
