This AASLD statement is only “Grade II”. The effectiveness of transplantation versus resection or percutaneous ablation still needs randomized controlled trials (RCTs). This need is not futile: (1) From the French national database, survival after transplantation for patients with HCC is

lower than for other indications (less than 70% versus more than 80% at 2 years, respectively) and at 5 years, survival after transplantation for HCC is 65%, a very serious issue considering the shortage of organs.2 (2) Resection for small solitary HCC in compensated cirrhosis yields an overall survival rate comparable to upfront transplantation.3 Surgery substantially contributes to improve health, but needs high-quality outcome data. Complex mathematical models cannot be used to bypass the complexities of the surgical

research framework. To limit complexity, we must begin at the beginning, namely, RCTs investigating the effectiveness of transplantation versus ablation and/or resection, or at least, the full find more publication of national series which are more relevant than short series of selected cases from a few leading centers. Hepatocellular carcinoma is a major health care issue which deserves both evidence-based medicine and evidence-based surgery.4 Alain Braillon*, * Public Health, University Hospital, Amiens, France. “
“Liposarcoma frequently

occurs in the retroperitoneum and lower extremities, accounting for 9.8–16% of all soft tissue sarcomas. Liposaromas vary by histology and can be classified into four types. Those four types are well differentiated, myxoid/round cell, pleomorphic and dedifferentiated. This classification corresponds to the clinical aspect and prognosis of patients. Dedifferentiated liposarcoma (DDL) has both a well differentiated liposarcoma and a high grade nonlipogenic sarcoma within the tumor. It is difficult to diagnose DDL histologically. DDL can show a variety of histological appearances. The most common phenotype is malignant fibrous histiocytoma. Other phenotypes include leiomyosarcoma, osteosarcoma, rhabdomyosarcoma, and angiosarcoma. For DDL, prognosis is generally ZD1839 solubility dmso poor compared with the other types of liposarcoma. It shows high recurrence rate of 40-83%, metastasis rate of 15–30%, and the overall 5-year survival rate of 20%. DDLs often originate in the retroperitoneum, extremities, trunk, testis, and spermatic cord. A 61-year-old man was admitted to our hospital with 38.8°C of fever and general weakness. He had a history of a 20 × 10 cm well-differentiated retroperitoneal liposarcoma and underwent debulking surgery and intraoperative radiotherapy eight years previously. After surgery, there was no remnant mass visible on the abdominal computed tomography (CT) scan.