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Liposarcoma — SCE Medical Oncology MCQ

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HardSarcomaLiposarcomaSCE Medical Oncology

After planned en-bloc resection of a primary retroperitoneal dedifferentiated liposarcoma, pathology reports a microscopically positive posterior margin against an unresected major vessel. Imaging shows no gross residual disease. Which postoperative approach reflects the 2024 UK sarcoma guideline?

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Correct answer: A — Review in the specialist retroperitoneal sarcoma MDT and enter risk-adapted surveillance rather than routine adjuvant treatment

Explanation lettering: B = shown as A · D = shown as B · E = shown as C · A = shown as D · C = shown as E

B is correct. Retroperitoneal sarcoma surgery aims for macroscopically complete en-bloc resection; a microscopic margin at a critical structure does not automatically mandate another operation. The 2024 UK guideline does not support routine postoperative radiotherapy, whose normal-tissue toxicity is substantial, or routine adjuvant chemotherapy after complete resection. Palbociclib and MDM2-directed agents remain investigational or advanced-disease strategies rather than adjuvant treatment selected by amplification alone. Re-resection is considered only after expert review of residual anatomy, histology, morbidity and whether meaningful oncological clearance is achievable. Here, no gross residual disease makes specialist surveillance the standard default.

Reference: 2024 UK soft-tissue sarcoma guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC11724041/