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. 2025 Mar 21;25(1):517.
doi: 10.1186/s12885-025-13813-w.

Clinical course and prognostic factors of patients with dedifferentiated liposarcoma: a retrospective analysis

Jelena Casier #  1 , Iris Timmermans  2 , Annouschka Laenen  3 , Daphne Hompes  4 , Thomas Douchy  4 , Raf Sciot  5 , Melissa Christiaens  6 , Hazem Wafa  7 , Patrick Schöffski #  2
Affiliations

Clinical course and prognostic factors of patients with dedifferentiated liposarcoma: a retrospective analysis

Jelena Casier et al. BMC Cancer. .

Abstract

Introduction: Dedifferentiated liposarcoma (DDLPS) is a fairly common subtype of soft tissue sarcoma, but relatively little is known about the clinical course and prognostic factors of this mesenchymal malignancy.

Methods: We performed a retrospective analysis of patients diagnosed with DDLPS at the University Hospital Leuven, Belgium between 1991 and 2022 based on an established clinical database and patient records.

Results: We identified 259 patients with DDLPS, with the retroperitoneum as most common location of the primary tumor (47.5%). 204/259 patients (78.8%) patients had primary surgery. Radiotherapy was administered in the pre- (46/259, 17.8%) or postoperative setting (51/259, 19.7%). At diagnosis 28/259 (10.8%) patients presented with locally inoperable disease and 26/259 (10.0%) with synchronous metastasis. In patients who had primary surgery, local relapses were seen in 114/259 (44.0%) patients and 80/259 (30.9%) patients developed metachronous metastasis. A total of 48/259 (18.5%) patients developed both local relapse and metastasis. Patients with inoperable or metastatic disease were often treated with systemic therapy. The most common first-line systemic therapies were doxorubicin (51/98, 52.0%), doxorubicin combined with ifosfamide (12/98, 12.2%) and different types of experimental treatments (18/98, 18.4%). The median overall survival from first diagnosis of DDLPS to death of all causes was 70.5 months (95% confidence interval [CI] 56.6-98.6) for all patients, 10.9 months (95% CI 3.6-29.2) in patients with inoperable disease, 28.4 months (95% CI 1.3-199.3) for patients with local relapse and only 9.4 months (95% CI 1.2-25.9) for patients with metastatic disease. We identified lower age, primary surgery, absence of synchronous metastasis, absence of local relapse and treatment with experimental therapy as statistically significant favorable prognostic factors.

Conclusions: DDLPS is a subtype of soft tissue sarcoma with an aggressive clinical course and very poor prognosis, especially in patients with inoperable or metastatic disease. The results with classic chemotherapy are poor, and experimental treatments may be a preferred choice for individual patients. Data from this retrospective series can inform the design of future prospective and ongoing trials in this setting.

Keywords: Dedifferentiated liposarcoma; Prognostic factors; Treatment modalities.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: For this retrospective analysis we used an institutional research database at the University Hospitals of Leuven, containing information on patients with mesenchymal tumors (LECTOR, reference number S51495), after obtaining ethics approval from our institutional ethics committee: Research Ethics Committee UZ/KU Leuven (reference number MP024913). The Committee confirms that they work in accordance with the ICH-GCP principles (International Conference on Harmonisation Guidelines on Good Clinical Practice), with the most recent version of the Helsinki Declaration, and with applicable laws and regulations. Informed consent from individual participants was deemed unnecessary according to this framework. Consent for publication: Not applicable. Competing interests: PS has a consulting or advisory role at Ellipses Pharma, Deciphere, Transgene, Exelixis, Boehringer Ingelheim, Studiecentrum voor Kernenergie, Adcendo, PharmaMar, Merck Healthcare KGaA, Medpace, Cogent Biosciences, Eisai, Curio Science, LLX Solutions, SERVIER, Genmab, Sanofi, Regeneron, Moleculin Biotech, Avacta Life Sciences, Amryt Pharma, UCB, Boxer Capital, NEC OncoImmunity AS, Sonata Therapeutics, IDRx, Telix Pharmaceuticals. He received research funding from CoBioRes NV, Eisai, G1 Therapeutics, PharmaMar, Genmab, Merck, Sartar Therapeutics, ONA Therapeutics, Adcendo.The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Supernumerary ring and giant marker chromosomes
Fig. 2
Fig. 2
Kaplan Meier estimate for overall survival of all patients (+ 95% confidence interval)
Fig. 3
Fig. 3
Kaplan-Meier estimate for overall survival (OS) and progression-free survival (PFS) with first line systemic therapy
See this image and copyright information in PMC

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