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Comparative Study
. 2017 Dec;60(6):399-407.
doi: 10.1503/cjs.005917.

Comparison of retroperitoneal liposarcoma extending into the inguinal canal and inguinoscrotal liposarcoma

Jinsoo Rhu  1 , Chan Woo Cho  1 , Kyo Won Lee  1 , Hyojun Park  1 , Jae Berm Park  1 , Yoon-La Choi  1 , Sung Joo Kim  1
Affiliations
Comparative Study

Comparison of retroperitoneal liposarcoma extending into the inguinal canal and inguinoscrotal liposarcoma

Jinsoo Rhu et al. Can J Surg. 2017 Dec.

Abstract
in English, French

Background: This study was designed to analyze differences between retroperitoneal liposarcoma (RLPS) extending into the inguinal canal and inguinoscrotal liposarcoma.

Methods: We retrospectively reviewed the records for patients who were managed for inguinal liposarcoma at Samsung Medical Center, a tertiary hospital, between January 1998 and December 2016. Patient data on demographics, tumour location, surgery, adjuvant therapy, histology, recurrence and death were collected. We used Mann-Whitney, Fisher exact and Kaplan-Meier log-rank tests to analyze differences between groups.

Results: Seven of 179 (3.9%) patients with abdominal liposarcoma had inguinoscrotal liposarcoma, and 6 of 168 (3.6%) patients with RLPS had extension to the inguinal canal. No differences were observed between groups in sex (p > 0.99), mean age (49.7 ± 6.4 yr v. 52.1 ± 12.5 yr, p = 0.37), laterality (p > 0.99) or scrotal involvement (40.0% v. 66.7%, p = 0.57). The RLPS group had significantly larger tumours than the inguinoscrotal group (27.9 ± 6.8 cm v. 7.8 ± 4.2 cm, p = 0.001). Postoperative complications were significantly more common in the RLPS group (n = 4, 83.3%); patients in the inguinoscrotal group experienced no postoperative complications (p = 0.021). Log-rank tests showed that the groups had no statistical differences in disease-free survival (p = 0.94) or overall survival (p = 0.10). However, inoperable disease-free survival was significantly poorer in the RLPS group (p = 0.010).

Conclusion: Although initial signs and symptoms can be similar, RLPS extending into the inguinal canal was associated with significantly higher morbidity and mortality than inguinoscrotal liposarcoma.

Contexte: Cette étude visait à examiner les différences entre le liposarcome rétropéritonéal s'étendant au canal inguinal et le liposarcome inguino-scrotal.

Méthodes: Nous avons procédé à une analyse rétrospective des dossiers de patients traités pour un liposarcome inguinal au Samsung Medical Center, un hôpital de soins tertiaires, entre janvier 1998 et décembre 2016. Nous avons recueilli les données des patients en ce qui a trait aux caractéristiques démographiques, au siège de la tumeur, à la chirurgie, au traitement adjuvant, à l'histologie, à la récidive et au décès. Nous avons utilisé le test de Mann-Whitney, la méthode exacte de Fisher et les tests logarithmiques par rangs de Kaplan-Meier pour analyser les différences entre les 2 groupes.

Résultats: Sept des 179 (3,9 %) patients atteints de liposarcome abdominal avaient un liposarcome inguino-scrotal, et 6 des 168 (3,6 %) patients atteints de liposarcome rétropéritonéal présentaient une extension au canal inguinal. Aucune différence n'a été observée entre les groupes pour le sexe (p > 0,99), l'âge moyen (49,7 ± 6,4 ans c. 52,1 ± 12,5 ans, p = 0,37), la latéralité (p > 0,99) ou l'atteinte scrotale (40 % c. 66,7 %, p = 0,57). La taille de la tumeur était significativement plus grande dans le groupe du liposarcome rétropéritonéal que dans celui du liposarcome inguino-scrotal (27,9 ± 6,8 cm c. 7,8 ± 4,2 cm, p = 0,001). De même, les complications postopératoires étaient significativement plus courantes dans le groupe du liposarcome rétropéritonéal (n = 4, 83,3 %), les patients du groupe du liposarcome inguino-scrotal n'en ayant pratiquement pas présenté (p = 0,021). Les tests logarithmiques par rangs ont révélé l'absence de différences statistiques entre les groupes pour la survie sans récidive (p = 0,94) et la survie globale (p = 0,10). Cependant, la survie sans récidive du patient inopérable était significativement plus faible dans le groupe du liposarcome rétropéritonéal (p = 0,010).

Conclusion: Malgré la similarité des premiers signes et symptômes, le liposarcome rétropéritonéal s'étendant au canal inguinal était associé à des taux de morbidité et de mortalité significativement plus élevés que le liposarcome inguino-scrotal.

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Conflict of interest statement

Competing interests: None declared.

Figures

Fig. 1
Fig. 1
Patients who underwent surgery for abdominal liposarcoma at Samsung Medical Center. LPS = liposarcoma.
Fig. 2
Fig. 2
Computed tomography scans of patients with retroperitoneal liposarcoma extending into the inguinal canal. A) Patient 1 had a 28 cm mass occupying the right hemiabdomen with right inguinal protrusion. B) Patient 2 had a 30 cm mass occupying the entire abdomen with right inguinal protrusion. Patient 3 had C) an 18 cm mass in the pelvis reaching to the lower pole of the left kidney D) with extension through the left inguinal canal. E) Patient 4 had a 22.5 cm mass in the pelvis with protrusion through the left inguinal canal. F) Patient 5 had a 32 cm mass occupying the entire abdomen with protrusion through the right inguinal canal. Patient 6 had G) a protrusion through the left inguinal canal H) that originated from a 37 cm mass occupying the left hemiabdomen. Arrows indicate the mass of origin, and arrowheads indicate protrusion of the mass in the inguinal canal.
Fig. 3
Fig. 3
Image findings of patients with inguinoscrotal liposarcoma. A) Patient 7 had a 4.5 cm mass in the inguinal canal. B) Patient 8 had a 4 cm mass in the inguinoscrotal region. C) Patient 9 had recurrence in the left inguinal canal after previous excision of an 8 cm mass. D) Patient 10 had a 12 cm mass in the inguinoscrotal region. E) Patient 11 had a 3 cm mass in the right inguinoscrotal region. F) Patient 12 had a 9 cm mass in the left inguinoscrotal region. Patient 13 had G) a 14 cm mass in the right inguinal canal on magnetic resonance imaging, with H) hypermetabolic features on positron emission tomography. Arrowheads indicate a mass in the inguinal canal.
Fig. 4
Fig. 4
Survival curves of patients with retroperitoneal liposarcoma (RLPS) extending into the inguinal canal and patients with inguinoscrotal LPS (ILPS). A) Groups had no differences in disease-free survival (p = 0.94). B) Overall survival did not differ significantly between the groups (p = 0.10). C) Inoperable disease-free survival was significantly poorer in the RLPS group than the ILPS group (p = 0.010).
See this image and copyright information in PMC

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