Primary and locally recurrent retroperitoneal soft-tissue sarcoma: Local control and survival

• Published in: European journal of surgical oncology Vol. 35; no. 9; pp. 986 - 993
• Main Authors: Lehnert, T, Cardona, S, Hinz, U, Willeke, F, Mechtersheimer, G, Treiber, M, Herfarth, C, Buechler, M.W, Schwarzbach, M.H.M
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2009
• Subjects: Adult; Disease-Free Survival; Female; Follow-Up Studies; Hematology, Oncology and Palliative Medicine; Humans; Local recurrence; Long-term prognosis; Male; Middle Aged; Multivariate Analysis; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Proportional Hazards Models; Retroperitoneal Neoplasms - pathology; Retroperitoneal Neoplasms - surgery; Retroperitoneal sarcoma; Sarcoma - pathology; Sarcoma - surgery; Soft Tissue Neoplasms - pathology; Soft Tissue Neoplasms - surgery; Surgery; Survival; Survival Analysis; Treatment Outcome; Long-term prognosis; Retroperitoneal sarcoma; Survival; Surgery; Local recurrence
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2008.11.003

Abstract Aim To evaluate local control for long-term prognosis in retroperitoneal soft-tissue sarcoma (primary tumors (PT) and local recurrence (LR)). Methods A total of 110 patients underwent surgery between 1988 and 2002. Prospectively gathered clinicopathological data were analyzed. Kaplan–Meier estimations and Cox regression analyses were performed. Results Resectability was 90%, being comparable for PT ( n = 71) and LR ( n = 39). Morbidity, mortality, blood loss, and operation time did not differ for PT or LR (24% vs. 31%, p = 0.41; 7.0% vs. 5.1%, p = 1.0; 1000 ml vs. 1500 ml, p = 0.17; 240 min vs. 255 min, p = 0.13). Hospitalization was comparable in both groups (median, 12 days (PT) and 13 days (LR)). Follow-up was 89 months (median, IQR 37–112 months). Local 3- and 5-year control rates after complete resection of PT were 66% and 59% (19% and 9% for LR, p < 0.001). The mean number of operations were 1.4 for PT and 2.4 for LR ( p = 0.0047). The 5-year survival rates after complete resection were 51% for PT and 43% for LR ( p = 0.39 ) . The 5-year survival rates were 65%, 4%, and 0% for complete resection, incomplete resection, and exploration, respectively ( p < 0.001). Multivariate analysis showed high-grade and blood loss with a poor prognosis. Conclusions Comparable resectability rates and perioperative outcome were observed for surgery of PT and LR. Consequent reoperation leads to respectable long-term survival rates after resection of LR. The prognosis in retroperitoneal sarcomas varies significantly according to resectability, grade and blood loss.