Objective: Retroperitoneal liposarcoma is a rare malignant tumor derived from fat cells, and its clinicopathological characteristics remain unclear. This study aims to explore the clinicopathological characteristics of retroperitoneal liposarcoma in the Chinese population based on nearly 20 years of diagnosis and treatment experience in a single center.
Methods: We retrospectively collected the clinical and pathological data of patients with retroperitoneal liposarcoma who were diagnosed and treated at Renji Hospital, Shanghai Jiao Tong University School of Medicine from 2004 to 2023. Recurrence and prognosis information of the patients was obtained through outpatient follow-up or telephone follow-up.
Results: Over the past 20 years, Renji Hospital has diagnosed and treated a total of 172 patients with retroperitoneal liposarcoma, including 96 males and 76 females. These patients have undergone 297 hospitalizations and 228 surgeries at Renji Hospital. The overall survival rates at 3, 5, and 10 years were 73.3%, 60.0%, and 36.8%, respectively. The pathological subtype transformation rate of retroperitoneal liposarcoma was 32.2%. On average, each patient underwent 2.3 surgeries, with the maximum number of surgeries being 12. In addition to the tumor, 52.8% of patients had surrounding organs resected, with the kidney (21.0%) being the most commonly resected organ. The perioperative mortality rate was 2.2%, and the incidence of unplanned reoperations was 1.8%. The overall complication rate was 15.4%, with small bowel obstruction being the most common complication (21.2%). 13.1% of patients received adjuvant therapy other than surgery. However, only one patient received systematic adjuvant therapy according to the guidelines at that time.
Conclusion: Retroperitoneal liposarcoma is a rare malignant disease with favorable prognosis. Surgery is the main method to treat retroperitoneal liposarcoma, and postoperative recurrence is the biggest obstacle to its therapeutic effect. Currently, standardized adjuvant therapy for retroperitoneal liposarcoma still needs to be strengthened, and the development of effective drugs is also a direction that requires significant attention in the future.
Objective: To investigate the clinical application of sandwich bridging technique for constructing vascularized patches to repair large abdominal wall defects (LAWD) following abdominal wall tumor resection.
Methods: A retrospective analysis was conducted on patients who underwent bridging repair after extensive abdominal wall tumor resection. All procedures were performed by the same surgical team from Huadong Hospital Affiliated to Fudan University and Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2016 and December 2023.
Results: A total of 29 patients with LAWD after abdominal wall tumor resection were repaired using the sandwich bridging technique. Among them, 23 patients (75.9%) had type Ⅱ abdominal wall defects, and 6 patients (24.1%) had type Ⅲ abdominal wall defects. The mean tumor area was (132.1±56.3) cm2, and the mean defect area was (404.5±158.6) cm2. The average operation time was (250.2±99.6) min, with intraoperative blood loss of (381.0±399.2) mL. The mean follow-up period was (50.9±24.5) months. The incidence of abdominal wall hernia or bulge was 6.9%, and the incidence of incision-related complications was 17.2%.
Conclusion: The sandwich bridging technique for constructing vascularized patches is feasible for repairing LAWD caused by abdominal wall tumors.
Retroperitoneal liposarcoma poses significant therapeutic challenges due to its unique anatomical location and biological characteristics. Recent advancements in surgical techniques, the optimization of radiotherapy strategies, and the development of novel pharmacological agents have greatly transformed the treatment landscape. Surgical management has shifted from solely focusing on radical resection to strategies that balance complete tumor removal and organ function preservation. Multidisciplinary team approaches have demonstrated significant improvements in patient prognosis by integrating expertise across surgery, radiology, pathology, and oncology. Radiotherapy, supported by precision techniques, serves as a complementary treatment for local tumor control. However, its efficacy remains constrained by factors such as tumor histology and radiation dosage limitations. In pharmacotherapy, traditional cytotoxic chemotherapy is increasingly being supplanted by targeted therapies and immunotherapy combinations, while breakthroughs in molecular subtyping and liquid biopsies are paving the way for personalized treatment approaches. Looking ahead, the integration of radiomics, artificial intelligence-supported treatment strategies, and multimodal combination therapies is expected to advance retroperitoneal liposarcoma management. This evolution is anticipated to achieve a better balance between radical surgical intervention and quality-of-life preservation, thus delivering substantial survival benefits and improved outcomes for patients.
Soft tissue sarcoma (STS) is a rare malignant tumor originating from mesenchymal tissues, with over 50 histological subtypes and significant clinical heterogeneity, making treatment particularly challenging. Although comprehensive treatment primarily focusing on surgical resection plays an important role in local control, the prognosis for patients with advanced or metastatic disease remains poor, and the benefits of traditional chemotherapy are limited. In recent years, with advances in molecular biology and genomics, targeted therapy has emerged as a new treatment strategy for STS, enabling effective modulation of tumor biological behavior through precise identification of driver genes and abnormal signaling pathways. Currently, anti-angiogenic agents, multi-target tyrosine kinase inhibitors (TKIs), mammalian target of rapamycin (mTOR) and cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, as well as novel agents targeting neurotrophic tyrosine receptor kinase (NTRK) fusions and enhancer of zeste homolog 2 (EZH2) epigenetic regulation, have all demonstrated clinical benefits in various STS subtypes. This review summarizes recent progress in molecular targeted therapy for STS, including combination treatment strategies and resistance mechanisms, and discusses its clinical application prospects and existing challenges, aiming to provide a reference for clinical practice. In the future, continuous exploration of new molecular targets, optimization of combination regimens, and overcoming drug resistance will be essential to advance STS treatment towards precision and personalization, ultimately bringing longer survival and improved quality of life for patients.
Retroperitoneal sarcoma (RPS) is a rare malignant tumor originating from the retroperitoneal mesenchymal tissue. While surgical resection remains the cornerstone of curative treatment, a significant challenge is the high rate of local recurrence, underscoring the critical need for effective multimodality approaches. Radiotherapy, as an important means of local treatment, has been demonstrated to play a corresponding role in neoadjuvant, intraoperative, and adjuvant settings. Notably, preoperative radiotherapy is recommended as an effective treatment approach due to its capacity to enhance the rate of local control. Furthermore, with the continuous advancement of radiotherapy technology, proton and heavy ion therapies have shown significant advantages. Compared to traditional photon radiation therapy, they can enhance the radiosensitivity of RPS and provide better protection for organs at risk. This comprehensive review synthesizes recent evidence from landmark studies to delineate current practice patterns, analyze ongoing controversies, and highlight technological innovations shaping the radiotherapeutic management paradigm for RPS.
Retroperitoneal sarcoma (RPS) is a kind of highly heterogeneous soft tissue tumor. Radical surgery remains the mainstay of treatment. However, the high postoperative local recurrence rate significantly impacts long-term survival. The efficacy of traditional systemic chemotherapy in RPS is limited, necessitating the exploration of more effective adjuvant treatment strategies to reduce the local recurrence rate. This paper summarizes the current status of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of RPS, along with recent advances in basic and clinical research. We explore the potential value of HIPEC in reducing postoperative recurrence of soft tissue sarcomas and improving patient prognosis. The combination of cytoreductive surgery (CRS) and HIPEC has been shown to prolong both disease-free survival and overall survival in RPS patients, with particular benefits observed in specific pathological subtypes such as leiomyosarcoma and dedifferentiated liposarcoma. However, large-scale prospective studies on the efficacy of HIPEC in preventing postoperative recurrence of RPS are still lacking. Future research should focus on conducting multi-center, large-scale prospective studies to further validate the efficacy of HIPEC in RPS and to define the patient populations that may benefit the most from this approach.
Objective: To investigate the clinicopathological characteristics of sebaceous carcinoma (SC) and enhance the diagnostic accuracy and differential diagnosis capabilities among pathologists for this malignancy.
Methods: Clinical data from seven patients with sebaceous carcinoma (SC) were retrospectively reviewed, with comprehensive analysis of histopathological features and immunohistochemical characteristics in all cases.
Results: In this study, sebaceous carcinoma (SC) predominantly affected elderly female patients, with a median age of 65 years (male-to-female ratio = 1：2). The majority of cases (6/7) represented periocular SC, with the left upper eyelid being the most frequently involved anatomical site（5/7）. Histopathological examination revealed that all seven SC cases exhibited predominantly nested or lobulated growth patterns, intraepidermal infiltrative growth was observed in 4 cases. Variable sebaceous differentiation with additional morphological characteristics were noted. Including tumor necrosis (n=5)、ductal differentiation (n=2)、keratinization(n=2)、perifollicular growth pattern (n=2) and cystic degeneration (n=1). Immunohistochemistry showed that tumor cells were positive for epithelial membrane antigen (EMA) and androgen receptor (AR), negative for carcinoembryonic antigen (CEA), and highly expressed for nuclear associated antigen Ki-67 (Ki-67).
Conclusion: Sebaceous carcinoma (SC) represents a rare cutaneous malignancy characterized by histologically evident sebaceous differentiation. While classical SC exhibits distinctive morphological features, significant histological heterogeneity may occur. Therefore, accurate diagnosis requires comprehensive evaluation incorporating both architectural features and immunohistochemical profiling to reliably distinguish SC from its histological mimics.
Objective: To explore the influencing factors of acute radiation dermatitis (ARD) in patients with breast cancer who received radiotherapy after breast conserving surgery, so as to identify the patients who need close monitoring.
Methods: This study included 281 patients with breast cancer who received radiotherapy in the Department of Radiotherapy of the Tenth People’s Hospital Affiliated to Tongji University from January 1, 2020 to December 31, 2023 after breast conserving surgery. Clinical records were collected, and platelet counts and cytokines including IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17A, TNF-a, IL-12p70, IFN-α and IFN-γ in peripheral blood were measured. The relationship between clinical pathological features, radiotherapy methods, laboratory examination indicators, and ARD was evaluated.
Results: Among 281 patients receiving radiotherapy after breast conserving surgery for breast cancer, 39 patients (13.9%) developed grade 2 ARD or higher. The results of univariate analysis showed that lymph node staging, hospitalization during radiotherapy, radiotherapy segmentation method, regional lymph node irradiation, affected breast volume, platelet count, and IL-5 level were associated with grade 2 ARD or higher. The results of multivariate logistic analysis showed that hospitalization during radiotherapy, radiotherapy segmentation method, and platelet count were independent risk factors for the occurrence of grade 2 ARD or higher (P＜0.05).
Conclusion: For patients undergoing radiotherapy in outpatient clinics, using conventional fractionation methods for radiotherapy, and having high platelet counts before radiotherapy, special attention should be paid to skin management in the irradiation area to reduce the occurrence of ARD.
