Treatment of Localised, Resectable, Low-Grade (Grade 1) Liposarcoma of an Extremity or Superficial Trunk
This protocol covers the management of grade 1 liposarcoma that is localised, clinically resectable, and confined to an extremity or the superficial trunk — a setting in which curative-intent treatment is the goal.
Clinical Scenario
Localised, clinically resectable, low-grade (grade 1) liposarcoma of an extremity or superficial trunk — surgically approachable with intent to achieve local control.
Treatment Approach (Partial Overview)
Surgery is the standard treatment in this setting, aiming for complete resection. Radiotherapy may additionally be considered in selected cases based on histology and anatomical location…
References
DOI: 10.1016/j.annonc.2021.07.006
- Localised, clinically resectable, extremity and superficial trunk STS
- Grade 1
- Surgery is the standard treatment for all patients with an adult-type, localised STS.
- The standard surgical procedure is an en bloc excision with R0 margins.
- This implies removing the tumour in a single specimen with a rim of normal tissue around it [II, A].
- As an individualised option, R1 excision can be acceptable in carefully selected cases; in particular, marginal excisions along the pseudocapsule are advised for atypical lipomatous tumours [IV, B].
- RT should be delivered with the most appropriate technique available [including but not limited to intensity-modulated RT (IMRT) and particle therapy in challenging sites], to a total dose of 50 Gy in 1.8-2 Gy fractions in the preoperative setting.
- In the post-operative setting, doses up to 66 Gy are given, depending on presentation, age and resection margins.
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