Extensive adipocytic maturation can be seen in myxoid liposarcomas treated with neoadjuvant doxorubicin and ifosfamide and pre-operative radiation therapy.docVIP

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Extensive adipocytic maturation can be seen in myxoid liposarcomas treated with neoadjuvant doxorubicin and ifosfamide and pre-operative radiation therapy.doc

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Extensive adipocytic maturation can be seen in myxoid liposarcomas treated with neoadjuvant doxorubicin and ifosfamide and pre-operative radiation therapy

Wangetal.ClinicalSarcomaResearch2012,2:25 /content/2/1/25 CLINICAL SARCOMA RESEARCH RESEARCH OpenAccess Extensiveadipocyticmaturationcanbeseenin myxoidliposarcomastreatedwithneoadjuvant doxorubicinandifosfamideandpre-operative radiationtherapy Wei-LienWang1,DanielaKatz2,DejkaMAraujo3,VinodRavi3,JosephALudwig3,JonathanCTrent4, ShreyaskumarRPatel3,PatrickPLin5,AshleighGuadagnolo6,DoloresLòpez-Terrada7,AngeloPaoladeiTos8, ValerieOLewis5,DinaLev9,10,RaphaelEPollock10,11,GunarKZagars6,RobertSBenjamin3,JohnEMadewell12 andAlexanderJLazar1,10* Abstract Background:Trabectedinandthioglitazoneshavebeendocumentedtoinduceadipocyticmaturationinmyxoid liposarcoma;wehavenotedthisinourexperienceaswell.Intriguingly,wehavealsoencounteredthissame phenomenoninmyxoidliposarcomasexposedtovariouscombinationsofneoadjuvantdoxorubicinandifosfamide systemicchemotherapywithpreoperativeradiation,wherethepathologicaleffectshavebeenlesscharacterized. Weexaminedthehistologicalchanges,includingadipocyticmaturation,associatedwiththistreatmentinpatients withmyxoidliposarcomaandevaluatedforprognosticsignificance. Methods:Twenty-twopatientswereidentifiedwithhistologicallyconfirmedmyxoidliposarcomas(9withvariable hypercellularareas)whoweretreatedwithneoadjuvantdoxorubicin(75-90mg/m2/continousinfusionover72h every3week)andifosfamide(2.5g/m2dailyx4every3weeks)for4-6cycles.Twenty-onepatientsreceived pre-operativeradiationincluding5withconcurrentgemcitabine.Pre-andpost-treatmentMRIstudieswere comparedforchangesintumorarea,fatcontentandcontrastuptake,withthelattertwoestimatedas:none, 25%,25-49%and50%.Post-treatmentspecimenswereevaluatedforhyalinization,necrosisandadipocytic maturation.Clinicalfollow-upwasobtained. (Continuedonnextpage) *Correspondence:alazar@ 1DepartmentofPathology,TheUniversityofTexasMDAndersonCancer Center,1515HolcombeBlvdUnit085,Houston,TX77030,USA 10SarcomaResearchCenter,TheUniversityofTexasMDAndersonCancer Center,1515HolcombeBlvdUnit085,Houston,TX77030,USA Fulllistofauthorinformationis