Primary Retroperitoneal Soft Tissue Sarcomas: Results of Aggressive Surgical Treatment

Abstract

A retrospective study was undertaken to evaluate the results of surgical treatment in a series of patients with primary retroperitoneal sarcomas consecutively treated by the same surgical team. The hospital records of 42 patients with primary retroperitoneal sarcomas who underwent surgical exploration at our unit from 1984 to 1995 were reviewed. A univariate analysis was used to identify the main clinical, pathologic, and treatment-related factors affecting long-term survival. Twenty-five patients (59.6%) underwent radical surgery. The 5-year survival and 5-year disease-free survival after radical resection were 48.1% and 38.8%, respectively. According to the univariate analysis of survival tumor classification (T), stage and gross surgical margins significantly affected prognosis. The study indicates that even though there are predetermined and unmodifiable tumor-related factors, such as tumor classification (T) and stage, that influence survival in patients with retroperitoneal sarcomas, wide surgical excision offers a concrete chance for long-term survival.

Prognostic Factors of Retroperitoneal Soft-Tissue Sarcomas

“…Thus, it is often difficult to obtain a margin of normal tissue around the tumor [13]. Complete resection varies from 38 to 74% in most reports [3,9,15]. The rate of complete resection in this study was 66.7%.…”

“…Patients with RSTS tend to have a poor prognosis with a high local recurrence rate and a low 5-year survival rate [1,2,5]. Surgery is the principal mode of therapy and offers the most favorable prognosis after complete resection [1][2][3]6]. In this study, we aimed to evaluate the morbidity, the mortality, and the prognostic factors that affect survival of the patients with RSTS.…”

“…Only 10-15% of them are located in the retroperitoneum. RSTS tend to be relatively large compared to tumors elsewhere in the body [1][2][3]. The various types of retroperitoneal sarcomas are derived from mesenchymal cells that present as different histologic types depending on their cell origin.…”

Renal sparing surgery for perirenal liposarcoma: 24 months recurrence free follow up

“…Histological subtype appeared to influence the pattern of recurrence, which was mainly local for patients with liposarcoma. Several authors have noted that tumor negative surgical margins are associated with a reduced risk of local recurrence and improved disease specific survival, especially in patients with low-grade retroperitoneal LPS (1,3,4). In both our case only limited involvement of renal parenchyma was observed at the time of surgery, which made renal sparing surgery a feasible option without compromising the oncological principle of tumor free margins.…”

“…In general, the biological behavior and prognosis of liposarcomas (LPS) are more favorable compared to most soft tissue sarcomas (STS) but the prognosis can vary widely depending on tumor characteristics, especially histological subtype and tumor grade (3). Emphasizing the importance of radical resection and tumor negative surgical margins for disease specific survival, these tumors have traditionally been treated with radical surgery sacrificing adjacent organs (1,(3)(4)(5). Multiple trials of chemotherapy and radiation therapy have shown no survival benefit.…”