Surgical management of truncal and extremities atypical lipomatous tumors/well-differentiated liposarcoma: A systematic review of the literature

Atypical lipomatous tumors or well-differentiated liposarcomas (ALT/WDLS) are low-grade soft tissue tumors that are commonly located on the trunk and extremities. There is no consensus on the best surgical approach for ALT/WDLS. A systematic literature review of PubMed, Medline, Embase, Scopus, and...

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Bibliographic Details
Published in:The American journal of surgery 2020-05, Vol.219 (5), p.823-827
Main Authors: Choi, Kyoo-Yoon, Jost, Evan, Mack, Lloyd, Bouchard-Fortier, Antoine
Format: Article
Language:English
Subjects:
Adipocytes
Atypical lipoma
Clinical outcomes
Cytogenetics
Extremities
Histology
Histopathology
Liposarcoma
Literature reviews
Low grade liposarcoma
Metastases
Metastasis
Morbidity
Mortality
Patients
Soft tissues
Studies
Systematic review
Tumors
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Summary:Atypical lipomatous tumors or well-differentiated liposarcomas (ALT/WDLS) are low-grade soft tissue tumors that are commonly located on the trunk and extremities. There is no consensus on the best surgical approach for ALT/WDLS. A systematic literature review of PubMed, Medline, Embase, Scopus, and google scholar was performed. All published studies on trunk or extremities ALT/WDLS with reported outcome data were considered and independently screened for inclusion by at least two of the authors. A total of eighteen studies comprising 793 patients with ALT/WDLS were included. 580 patients underwent marginal excision, with local recurrence observed in 69 (11.9%). 213 patients underwent wide excision with local recurrence in 7(3.3%). Recurrent tumors were successfully re-resected with marginal or wide excision. Dedifferentiation was confirmed in 9 patients (1.1%), and a distant pulmonary metastasis in 1 patient (0.1%). Marginal excision of truncal or extremities ALT/WDLS results in a slightly higher local recurrence rate. However, recurrences are almost always amenable to re-resection. The findings support the use of marginal excision for truncal or extremities ALT/WDLS. •Marginal excision of truncal or extremities ALT/WDLS results in a slightly higher local recurrence rate.•However, recurrences are almost always amenable to re-resection.•The findings support the use of marginal excision for truncal or extremities ALT/WDLS.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2020.01.046