Treatment of patients with primary retroperitoneal sarcoma: predictors of outcome from an Australian specialist sarcoma centre

Abstract

Background: Several unanswered questions surround the management of retroperitoneal sarcoma (RPS). Guidelines recommend treatment by a multidisciplinary team at a specialized referral centre. The objective of this study was to describe the management of RPS at an Australian specialist sarcoma centre, comparing outcomes to international standards and analysing for predictors of local failure. Methods: A retrospective review of a prospectively maintained database was performed on patients with RPS treated between 2008 and 2016. A 5-year outcome analyses focussed on patients undergoing curative-intent surgery for primary, non-metastatic RPS. Results: Eighty-eight patients underwent surgery for primary RPS. Five-year overall survival was 66%, 5-year freedom from local recurrence was 65% and 5-year freedom from distant metastasis was 71%. Overall survival was associated with tumour grade (hazard ratio (HR) 6.1, P < 0.001) and histologic organ invasion (HR 5.7, P < 0.001). Variables associated with improved freedom from local recurrence were macroscopically complete resection (HR 0.14, P < 0.001) and neoadjuvant radiotherapy (HR 0.33, P = 0.014). Treatment at a specialist sarcoma centre was associated with a higher rate of preoperative biopsy and neoadjuvant radiotherapy (both with P < 0.001). There was a trend towards improved local control for patients undergoing surgery at a specialist centre (P = 0.055). Conclusion: This is the largest Australian series of RPS and outcomes are comparable to major international sarcoma centres. Patients treated at a specialist centre had higher rates of preoperative diagnosis and tailored therapy which was associated with improved outcomes. Patients with suspected RPS should be referred to a specialist centre for optimal preoperative evaluation and multidisciplinary management.

A critical narrative review of radiotherapy for retroperitoneal soft tissue sarcoma

“…Similar results were observed for OS (119.4 vs. 75.9 months, P=0.04) (80). Some comparable results were also obtained in two previous series (81,82). Snow et al concluded that lack of NeoRT was a poor prognostic factor of LC (82).…”

“…Some comparable results were also obtained in two previous series (81,82). Snow et al concluded that lack of NeoRT was a poor prognostic factor of LC (82). In a recent systematic review of NeoRT in RPS, Cheng et al reported the results of 15 articles with 464 patients.…”

A case report of left lower lobe segmentectomy for pulmonary metastasis from retroperitoneal liposarcoma

“…Nevertheless, antitumor effects have been reported using various kinds of anticancer agents or molecular targeting drugs for unresectable cases of liposarcoma [[15], [16], [17]], but no effective regimen has yet been established. In the future, the establishment of a multidisciplinary treatment including radiation therapy, molecular target therapy and immune therapy is expected to treat liposarcoma, particularly for patients with initially unresectable advanced liposarcoma and recurrence after surgery [18,19].…”

Analysis of the Efficacy of Anlotinib in the Late-Line Treatment of Advanced Leiomyosarcoma: A Case Report

“…It occurs more commonly in people aged 40 to 70 years and in women, often grows aggressively and relapses easily after surgery. It can transfer to the lungs and liver through blood circulation, and the 5-year overall survival reported in the literature is 28%-40% [2][3][4][5]. This report describes the case of multiple metastasis of liver and lung in a female patient with pelvic leiomyosarcoma, and discusses its effective treatment.…”