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Zhuang et al. | Journal of Clinical and Translational Research 2024; 10(1): 62-71 67
liposarcoma. There were 177 patients in the study, and the 5-year
DSS for all patients was 60%. There were only 13 (7%) patients
with MLPS and RCLPS in the cohort, so the accuracy of prediction
for these patients was limited even though pathological type
was an independent prognostic factor for RLPS in multivariate
analysis [23]. Subsequently, MSKCC developed a DSS nomogram
prediction model using data from 801 liposarcoma patients
(including 144 MLPS and 81 RCLPS). Despite the 12-year DSS
of 72% for the entire cohort, the 12-year DSS for liposarcomas
of retroperitoneal origin in subgroups by site was only 32%.
This is consistent with our previous findings that the prognosis
for retroperitoneal MLPS/RCLPS is worse than other sites. The
researchers also developed a 5-year and 12-year DSS prediction
model with good verification based on age, presentation status,
primary site, histologic variant, tumor burden, and gross margin
status (C-index = 0.776) [28]. Gronchi et al. developed a nomogram
Figure 5. Disease-specific survival in patients with low-, medium-, and prediction model for RPS using data from 523 patients in 2013.
high-risk groups. The cohort’s 5-year OS rate was 56.8%. Although this study did
not differentiate the pathological subtype of myxoliposarcoma, it
findings, we recommend more active follow-up for patients in the has been externally validated and can accurately predict the DFS
middle- and high-risk groups and consideration for clinical trials and OS of patients, presenting significant implications for the
when permissible. diagnosis and treatment of RPS [29]. On the basis of pathological
In a retrospective cohort study, we found that retroperitoneal classification, MSKCC subsequently developed a DSS nomogram
MLPS/RCLPS differed from MLPS/RCLPS at other sites in prediction model for RPS. This nomogram can predict DSS at 3,
several ways. Firstly, the prognosis was poorer. In a study 5, and 10 years after surgery with high accuracy (C-index = 0.71).
conducted by Hans Roland Dürr in 2018 involving 43 cases In addition, it is also a fly in the ointment that, due to the rarity of
of MLPS/RCLPS, the 5-year and 10-year OS rates were 81% MLPS and RCLPS, MLPS is classified as WDLPS and RCLPS
and 72%, respectively [24]. In a study involving 174 cases of as DDLPS [30]. Compared to the aforementioned studies, the
primary MLPS/RCLPS reported by Fiore et al., the 5-year and nomogram established in this research focuses on retroperitoneal
10-year DSS rates for the MLPS and RCLPS group were 93% MLPS/RCLPS, providing more precise diagnosis and treatment
and 92%, and 87% and 77%, respectively. However, only 7% of for this relatively rare disease.
patients in the cohort were of retroperitoneal origin [10]. Based In recent years, numerous studies have explored the impact
on 85 patients with MLPS, Chowdhry et al. found that tumor of psychosocial factors on cancer outcomes, highlighting marital
size was the only factor affecting OS, and the 5-year OS in this status as an independent predictor of survival across different
study was 87.5% [25]. In 2020, 89 patients with MLPS/RCLPS cancer types. Research shows that unmarried individuals with
participated in a multicenter prospective cohort study, and their cancer tend to experience more advanced disease stages than their
3-year DSS was as high as 96%. Similarly, no retroperitoneal married counterparts. Married patients typically enjoy higher
patients were included in this study [26]. The patients in this socioeconomic status and better access to quality healthcare.
study cohort had a significantly worse prognosis than those in They also benefit from emotional and financial support from their
the preceding cohorts (5-year and 10-year DSS were only 64.0% spouses, enhancing their focus on the healing process. Notably,
and 47.1%, respectively). Second, the median age and tumor partner-provided emotional support can alleviate the stress
diameter of patients with retroperitoneal MLPS/RCLPS were also associated with cancer treatment. Social support within a marriage
significantly different. As an example, the median age of patients may influence cancer survival by affecting neuroendocrine,
in this study was 64 years, whereas in previous studies, it was less neurological, and immune interactions. For instance, higher social
than 50 years; the median tumor size was 20 cm, as opposed to support levels are associated with increased activity of natural
approximately 10 cm in previous studies. The Trans-Atlantic RPS killer (NK) cells, which play a crucial role in recognizing and
Working Group reported that the 10-year OS of RPS was 46%, the eliminating cancer cells. In addition, oxytocin hormone release
median age of patients in this cohort of 1007 patients was 58 years, during social interactions may indirectly inhibit cancer cell growth
and the median tumor size was 20 cm [27]. Retroperitoneal MLPS/ by suppressing stress responses [31-34].
RCLPS appears to have a prognosis more comparable to that of Marital status was found to be a risk factor for DSS. In
an RPS than systemic MLPS/RCLPS. In other words, even in univariate analysis, the tumor-specific survival of married
MLPS/RCLPS, the primary site may be as crucial to the patient’s patients was greater than that of widowed, divorced, and separated
prognosis as the pathological subtype. patients [35-37]. However, contrary to previous research, we
As early as 2003, Memorial Sloan-Kettering Cancer Center found that married patients had twice the risk of dying from
(MSKCC) conducted a nomogram study on retroperitoneal cancer compared to single (never-married) patients, even after
DOI: https://doi.org/10.36922/jctr.00113