Retroperitoneal soft tissue sarcomas

Abstract

BACKGROUNDThe objective of this study was to assess long‐term prognosis and patterns of failure in patients with retroperitoneal soft tissue sarcoma who underwent surgery with curative intent at a single institution. Several series of patients with retroperitoneal sarcoma were reported, providing widely variable data regarding local and distant failure.METHODSOverall, 167 consecutive patients who underwent surgery for retroperitoneal soft tissue sarcoma over a 20 year span at a single referral center were reviewed retrospectively. Eighty‐two patients presented with primary disease, whereas 85 patients had recurrent locoregional tumors. Surgical resection was considered macroscopically complete in 147 of 167 patients (88%).RESULTSOverall survival at 10 years after definitive surgery was approximately 27%, and the disease‐free survival was approximately 16%. Only a minority of patients developed distant metastases. The risk of recurrence was correlated with whether patients underwent surgery for primary disease or for recurrent disease; the 10 year disease‐free survival rate was 27% in the former group and 4.6% in the latter group. Histotype and malignancy grade were other prognostic factors, with the former found to be predictive of the pattern of failure and the latter predictive of overall survival.CONCLUSIONSLocal recurrence after primary surgery and high‐grade malignancy were associated with the worst survival. Histologic subtype appeared to influence the pattern of recurrence, which mainly was local for patients with liposarcoma but was both local and distant for patients with the other histotypes. Cancer 2004. © 2004 American Cancer Society.

Clinical Investigations Surgery combined with brachytherapy in patients with retroperitoneal sarcomas

“…Unfortunately, treatment of local recurrence is associated (in significant percentage of cases) with consecutive local recurrence. In group of patients presented in international literature, the predominated group consisted of patients operated primarily not due to recurrence [32, 54, 56–58]. In our study we confirmed that treatment of primary retroperitoneal sarcomas is one of the major factor influencing prognosis ( on the basis of multivariate analysis with its limitation resulting from numerical amount of cases in analyzed group).…”

“…However, series of publications were released with multiple sets of data regarding the treatment results of patients with this type of cancer. [18, 23–32]. It seem like the best option for the longest distant survival rate is a radical resection during the primary surgery of retroperitoneal sarcoma [6, 18, 32, 33].…”

“…However, the majority of literature information are formulated on the basis of small group of patients with divergent data (5 year survival rate oscillating between 12% to 70%) [6, 15, 18, 23, 25, 32, 33, 47–59]. Moreover, it is difficult to find present – day data of patients treated with surgery as a sole way of treatment.…”

Intraduodenal sarcoma recurrence of retroperitoneal origin: an unusual cause for a duodenal obstruction

“…Liposarcoma is the most common histologic subtype of retroperitoneal sarcomas, with a higher local recurrence rate than non-liposarcomas (58% versus 22%) [6]. Even when tumor grade is taken into account, failure of disease control is mostly due to locoregional recurrence.…”

A Clinical phase I/II trial to investigate preoperative dose-escalated intensity-modulated radiation therapy (IMRT) and intraoperative radiation therapy (IORT) in patients with retroperitoneal soft tissue sarcoma

“…Complete excision with wide margins represents the mainstay of treatment, however even gross total resections are possible only in about 50% of the patients [2,3] because of the often locally advanced tumors which frequently already involve vital structures at time of diagnosis [3]. Even if gross total resection is possible, margins are typically narrow because of the normal tissue limitations [3,4] consequently the local failure rate after surgery alone remains high [5-7]. In accordance to extremity soft tissue sarcomas (STS), where randomized trials have demonstrated improved local control by the addition of radiation [8,9], considerable interest has been paid in the use of postoperative radiation approaches in retroperitoneal STS also.…”