What is the prognosis of liposarcoma?

Updated: Mar 18, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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The prognosis is affected by the type of liposarcoma present. In general, survival for extremity tumors is favorable. [9] The histologic grade of localized liposarcomas of the extremities may be the most important prognostic factor. [10]

The well-differentiated type and most myxoid types have favorable prognoses, with 100% and 88% 5-year survival rates, respectively. [11] However, these tumors are poorly circumscribed and locally recur after incomplete excision. Although they rarely metastasize, repeated local recurrences may cause the tumor to evolve into a higher grade of sarcoma or to dedifferentiate, in which case metastasis is possible. Between 1973 and 2015, 1756 patients with extremity myxoid liposarcomas were evaluated. The 5- and 10-year overall survival rates of the entire cohort were 86.4% and 75.9%, respectively. [12]

The form that a dermatologist is most likely to examine at biopsy is 1 of the 3 subtypes of a well-differentiated liposarcoma, that is, the lipomalike liposarcoma or atypical lipoma; the other 2, inflammatory and sclerosing, are less likely. The clinical outcome of this subtype is best predicted by the anatomical location. In the subcutis, lipomalike liposarcomas are often cured with local excision. Lipomalike liposarcomas rarely recur, and they do not metastasize. Use of the term atypical lipomatous tumor, a less serious designation for atypical lipoma, has been suggested.

Round-cell and poorly differentiated types have a poor prognosis. Each has a 5-year survival rate of about 50% because they recur locally and tend to metastasize quickly and widely, especially in poorly differentiated liposarcomas. The lungs and the liver are the most common sites of metastasis. .

Despite high-grade morphology, cutaneous liposarcomas have a favorable clinical prognosis.

For soft tissue sarcoma involving the popliteal fossa, despite a high rate of microscopically positive margins, the local recurrence rate reported is only 7%. [13]

Cutaneous and subcutaneous pleomorphic liposarcomas have a more favorable outcome compared with their deep-seated counterparts, a fact attributable to their small size and superficial location. [14]

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