Liposarcoma is a rare cancer that arises from fat cells in deep soft tissues, most often in the thigh, buttock, or inside the abdomen (retroperitoneum). It accounts for a significant proportion of soft‑tissue sarcomas but is still uncommon compared to more familiar cancers like breast or lung cancer. Many patients first notice a painless, slowly enlarging lump and don’t realise it could be malignant.​

This guide explains what liposarcoma is, how it presents, the main treatment options, and how survival rates differ by subtype and stage—so that patients and families know what questions to ask and what to expect.

 

What Is Liposarcoma?

• Liposarcoma is a malignant (cancerous) tumour of fat‑forming cells, distinct from common benign lipomas.​
• It usually grows in deep soft tissues of the limbs or retroperitoneum rather than in the superficial fat under the skin.
• It often affects adults between 40 and 70 years, with a slight male predominance in some series.​

Liposarcoma is not one single disease; it includes several subtypes with different behaviours and prognoses.

 

Subtypes of Liposarcoma

The main pathological subtypes are:​

• Well‑differentiated liposarcoma (WDL) / atypical lipomatous tumour
  • Slow‑growing, locally aggressive, low metastatic potential.
• Dedifferentiated liposarcoma (DDL)
  • Arises from WDL areas; more aggressive with higher metastatic risk.
• Myxoid / round‑cell liposarcoma
  • Intermediate behaviour; round‑cell areas indicate more aggressive disease.
• Pleomorphic liposarcoma (PLS)
  • Least common but one of the most aggressive forms.​

Type, size, location, and stage at diagnosis heavily influence treatment decisions and survival.

 

Common Symptoms and Warning Signs

Early liposarcoma may cause few or no symptoms. Typical features include:​

• Painless, enlarging lump in thigh, buttock, arm, or trunk.
• Deep mass in the abdomen causing:
  • Abdominal fullness or distension.
  • Early satiety, constipation, or back pain if large.
• Pain, numbness, or weakness if tumour compresses nerves or blood vessels.

Red flags that warrant urgent evaluation:

• Rapidly enlarging mass.
• Lump deeper than the muscle layer or >5 cm.
• New pain, functional limitation, or weight loss.

Any deep or growing soft‑tissue lump should ideally be assessed in a sarcoma‑experienced centre.

 

How Is Liposarcoma Diagnosed?

1) Clinical Examination and Imaging

• Detailed physical exam and history (growth speed, pain, prior radiation or genetic syndromes).
• MRI of limb/trunk masses or CT of abdomen/retroperitoneum is typically used to define size, depth, relation to vital structures.​

2) Biopsy

• Core needle biopsy under imaging guidance is standard.
• Distinguishes liposarcoma from benign lipoma or other sarcomas.
• Helps determine subtype and grade, which guide treatment.​

3) Staging

• CT chest (and sometimes PET‑CT) to look for lung or other distant metastases.
• Staging (localised vs metastatic and tumour size) informs prognosis.​

Treatment Options

Management is best planned by a multidisciplinary team (surgical oncologist, radiation oncologist, medical oncologist, radiologist, pathologist).

1) Surgery – Cornerstone of Treatment

• Goal is complete removal with negative margins (R0 resection) while preserving function as much as possible.
• For limb lesions, limb‑sparing surgery plus radiotherapy has largely replaced amputation in many cases.​
• Retroperitoneal liposarcomas often require complex surgery involving adjacent organs.

Surgery significantly improves survival in both localised and selected metastatic cases.​

2) Radiotherapy

• Used pre‑operative (neoadjuvant) or post‑operative (adjuvant) to reduce local recurrence, especially for high‑grade, deep, or large tumours.
• Data show that radiotherapy can improve local control and may benefit some subtypes like myxoid liposarcoma more than others.​

3) Chemotherapy and Systemic Therapy

• Role varies by subtype, grade, and stage.
• Anthracycline‑based regimens (e.g., doxorubicin ± ifosfamide) are common first‑line options in advanced or high‑risk cases.​
• Some subtypes (e.g., myxoid) show better responsiveness than well‑differentiated forms.
• Targeted agents and newer drugs are being evaluated for specific molecular alterations.​

 

Survival Rates: What Do the Numbers Show?

Survival depends strongly on stage, location, and subtype.​

From pooled data and cohort studies:

• Overall 5‑year survival for localised liposarcoma is commonly reported around 75–90%, but much lower for advanced disease.​
• In one large study, 5‑year survival was about 75% in patients without metastasis vs around 12% in those with distant metastases.​

Subtype‑wise examples reported in literature:

• Well‑differentiated liposarcoma (WDL):
  • Often has near 100% 5‑year survival when completely resected but high local recurrence.​
• Myxoid liposarcoma:
  • 5‑year survival around 80–90% in some series when adequately treated.​
• Round‑cell / dedifferentiated liposarcoma:
  • More aggressive; approximate 5‑year survival around 50% in some reports.​
• Pleomorphic liposarcoma:
  • Overall survival of about 50–55% at 5 years and around 40% at 10 years; distant stage associated with poor prognosis.​

These are averages; individual prognosis can be better or worse depending on age, overall health, tumour size, margins, and response to treatment.

 

Follow‑Up and Long‑Term Outlook

• Liposarcomas can recur locally even many years after treatment, especially WDL and retroperitoneal tumours.​
• Regular follow‑up with clinical exam and imaging (e.g., MRI/CT and chest imaging) is recommended for at least 10 years, often longer for high‑risk subtypes.​

Survivorship care should address:

• Physical rehabilitation and limb function.
• Pain management and psychological support.
• Surveillance for late effects of radiotherapy or chemotherapy.

FAQ

1) Is liposarcoma life‑threatening?
Liposarcoma can be life‑threatening, especially aggressive subtypes or when diagnosed at an advanced stage. However, many patients with localised, low‑grade subtypes such as well‑differentiated liposarcoma live long lives, particularly when tumours are fully removed with clear margins and followed closely. Survival rates above 75–90% at five years are reported for localised disease in several series.​

2) How can I tell a liposarcoma from a simple lipoma?
Clinically, both may present as fatty lumps, but suspicious features for liposarcoma include deep location (beneath muscle), large size (>5 cm), rapid growth, or pain/neurological symptoms. Definitive distinction requires imaging and biopsy; many benign lipomas never need biopsy, but any atypical or enlarging mass should be evaluated in a sarcoma‑experienced centre.​

3) Does chemotherapy always improve survival in liposarcoma?
Chemotherapy benefits depend on subtype and stage. Studies show that some high‑grade and metastatic liposarcomas have measurable responses to anthracycline‑based regimens, and patients who do not progress on first‑line chemotherapy tend to have better overall survival. However, chemotherapy is not routinely used for all low‑risk, localised tumours, where surgery (plus or minus radiotherapy) is usually sufficient. Individual treatment plans must be tailored by a sarcoma team.​