Key result
Expert histological revision and molecular biological analysis led to diagnosis reclassification in approximately 25% of cases and significantly improved the prognostic accuracy of 10-year disease-specific survival estimates for well-differentiated liposarcoma (80% vs 58%, p<0.004).
Why the study?
Does expert histological revision combined with molecular biological analysis improve diagnostic classification in liposarcoma patients compared to standard referring hospital classification?
Observational (n=331)
No
Does expert histological revision combined with molecular biological analysis improve diagnostic classification in liposarcoma patients compared to standard referring hospital classification?
Absolute Event Rate: 80% vs 58%
p-value: p=<0.004
Expert histological revision and molecular biological analysis frequently lead to reclassification of liposarcoma, which is critical for accurate prognosis and tailored treatment decisions.
May warrant expert review for liposarcoma; leaves open impact on treatment selection and outcomes.
BACKGROUND: Treatment decisions and prognosis assessment for liposarcoma is based on a classification that depends on morphological and genetic features. Revisions by experienced referral pathologists are often advocated. METHODS: The process of histopathological classification in referring hospitals and subsequently in a referral center in relation to molecular biological information is evaluated. A total of 331 consecutive liposarcoma patients were evaluated for the added value of histological review at time of referral. Subsequently, cases were reclassified with implementation of present-day molecular information. For all patients, complete data on staging, treatment, and follow-up were available. RESULTS: Upon histological revision, 15/54 (28%) diagnoses were reclassified in the first decade, 14/65 (22%) in the second, and 14/53 (26%) in the last decade. Molecular biological analysis enabled well-differentiated liposarcoma with or without dedifferentiated component to be better recognized as such and distinguished from myxoid liposarcoma and pleomorphic liposarcoma. Inclusion of cytogenetic information resulted in reclassification after revision in 4/18 (22%) cases in the first decade, 10/38 (26%) cases in the second decade, and 19/75 (25%) cases in the last decade. CONCLUSIONS: This study indicates that liposarcomas are heterogeneous tumors. Expert assessment and implementation of molecular biological analysis are valuable for adequate classification as a basis for treatment decisions.
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Vreeze et al. (2009) conducted an observational in Liposarcoma (n=331). Expert histological revision and molecular biological analysis vs. Original diagnosis by referring hospital was evaluated on 10-year disease-specific survival for well-differentiated liposarcoma (p=<0.004). Expert histological revision and molecular biological analysis led to diagnosis reclassification in approximately 25% of cases and significantly improved the prognostic accuracy of 10-year disease-specific survival estimates for well-differentiated liposarcoma (80% vs 58%, p<0.004).
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