Papalia Giuseppe Francesco, De Marco Giulia, Luciano Claudia, Sisca Luisana, Farsetti Pasquale, Vincenzi Bruno, Papalia Rocco
Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Rome, Italy.
Oncological Orthopaedics Department, IFO-IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy.
Diseases. 2025 Jun 6;13(6):177. doi: 10.3390/diseases13060177.
Myxoid liposarcoma (MLPS) is a malignant tumor that occurs predominantly in the deep soft tissues of the extremities. Preoperative radiotherapy (RT) is used to reduce tumor volume to achieve adequate surgical margins. This systematic review aims to evaluate the impact of preoperative RT on surgical margins, local recurrence (LR) rates, metastasis development, and overall survival in patients with MLPS and associated prognostic factors.
A systematic literature search was conducted by two reviewers following PRISMA guidelines on PubMed, Scopus, and the Cochrane Library on 30 November 2024. We included prospective and retrospective cohort studies published in English that evaluate surgical margin status, LR and metastasis rates, and survival outcomes in patients undergoing surgical excision of MLPS following neoadjuvant radiotherapy. Two authors extracted tumor characteristics, percentage of round cells (RCs), change in tumor volume post-RT, surgical margins, postoperative complications, LR and metastasis rates, survival rates, and related prognostic factors.
The twelve studies included in this review involved 1483 patients with a mean age of 44.8 years. Tumors were mostly located in the lower limbs, deeply localized, and larger than 5 cm in most cases. The average LR and metastasis rates were 5.2% and 17%, respectively. The mean 5-year and 10-year overall survival rates were 87% and 74%, respectively. Poor prognosis was associated with >5% RC components, tumors larger than 15 cm, deep localization, and inadequate surgical margins.
The management of MLPS requires a multidisciplinary approach. Preoperative radiotherapy offers several advantages in reducing tumor volume and facilitating the achievement of adequate surgical margins, finally improving local control and long-term outcomes.
黏液样脂肪肉瘤（MLPS）是一种主要发生于四肢深部软组织的恶性肿瘤。术前放疗（RT）用于缩小肿瘤体积以获得足够的手术切缘。本系统评价旨在评估术前放疗对MLPS患者手术切缘、局部复发（LR）率、转移发生情况、总生存率及相关预后因素的影响。
两名研究者按照PRISMA指南于2024年11月30日在PubMed、Scopus和Cochrane图书馆进行了系统的文献检索。我们纳入了以英文发表的前瞻性和回顾性队列研究，这些研究评估了新辅助放疗后接受MLPS手术切除患者的手术切缘状态、LR和转移率以及生存结局。两名作者提取了肿瘤特征、圆形细胞（RCs）百分比、放疗后肿瘤体积变化、手术切缘、术后并发症、LR和转移率、生存率及相关预后因素。
本评价纳入的12项研究涉及1483例患者，平均年龄44.8岁。肿瘤大多位于下肢，位置较深，多数情况下直径大于5 cm。平均LR率和转移率分别为5.2%和17%。5年和10年总生存率分别为87%和74%。预后不良与RC成分>5%、肿瘤直径大于15 cm、位置较深及手术切缘不足有关。
MLPS的治疗需要多学科方法。术前放疗在缩小肿瘤体积和促进获得足够手术切缘方面具有诸多优势，最终可改善局部控制和长期预后。
