Increasing Incidence of Liposarcoma: A Population-Based Study of National Surveillance Databases, 2001-2016.

Rare cancers, affecting 1 in 5 cancer patients, disproportionally contribute to cancer mortality. This research focuses on liposarcoma, an understudied rare cancer with unknown risk factors and limited treatment options. Liposarcoma incident cases were identified from the U.S. Surveillance, Epidemiology, and End Result (SEER) program and the combined SEER-National Program of Cancer Registries (CNPCR) between 2001-2016. Incidence rates (age-adjusted and age-specific), 5-year survival, and the time trends were determined using SEER*stat software. Three-dimensional visualization of age-time curves was conducted for males and females. SEER liposarcoma cases represented ~30% (n = 11,162) of the nationwide pool (N = 37,499). Both sources of data showed males accounting for ~60% of the cases; 82%-86% cases were identified among whites. Age-adjusted incidence was greater among males vs. females and whites vs. blacks, whereas survival did not differ by sex and race. The dedifferentiated (57.2%), pleomorphic (64.1%), and retroperitoneal (63.9%) tumors had the worse survival. Nationwide, liposarcoma rates increased by 19%, with the annual percent increase (APC) of 1.43% (95% confidence interval (CI): 1.12-1.74). The APC was greater for males vs. females (1.67% vs. 0.89%) and retroperitoneal vs. extremity tumors (1.94% vs. 0.58%). Thus, incidence increased faster in the high-risk subgroup (males), and for retroperitoneal tumors, the low-survival subtype. The SEER generally over-estimated the rates and time trends compared to nationwide data but under-estimated time trends for retroperitoneal tumors. The time trends suggest an interaction between genetic and non-genetic modifiable risk factors may play a role in the etiology of this malignancy. Differences between SEER and CNCPR findings emphasize the need for nationwide cancer surveillance.

Limited flow cytometry panels on bone marrow specimens reduce costs and predict negative cytogenetics.

OBJECTIVES: To determine the clinical and financial impact and predictive value of a limited flow cytometry strategy in the evaluation of bone marrow specimens. METHODS: Consecutive bone marrow cases (n = 1,242) were reviewed following the independent, prospective application of two flow cytometry protocols: a limited marker strategy and a multimarker strategy. Combined morphologic and flow cytometry findings were also compared with cytogenetic results. RESULTS: A limited flow cytometry strategy did not have a negative impact on disease detection and resulted in reduced utilization and cost. In addition, negative combined morphology and flow cytometry had a 98.4% predictive value for negative cytogenetics (P < .001). CONCLUSIONS: Careful initial evaluation of bone marrow specimens can markedly reduce the costs of bone marrow examination and significantly reduce the need for flow cytometric and cytogenetic studies on these samples.