Management and prognosis of primary and recurrent retroperitoneal soft tissue sarcoma

Abstract EN

Retroperitoneal sarcomas are rare tumor accounting for approximately 15 % of all soft tissue sarcomas.

Surgical resection of localized tumors with gross and microscopically negative margins remains the standard of care.

However, because retroperitoneal soft tissue sarcoma are frequently large and locally advanced, resections are often incomplete resulting in local recurrence, investigators are evaluating combined modality therapies to improve local control and disease specific survival.

The aim in this study is to evaluate the result of surgical treatment and long-term outcome of patients with retroperitoneal soft tissue sarcoma (RSTS).

Between April 2002 and January 2007, 34 patients (15 males & 19 females ; mean age 56 years, range 25-77 years), were evaluated complete resection was defined as removal of gross tumor with histologically confirmed clear resection margins.

Twenty-eight out of 34 patients (82 %) (15 were affected by primary retroperitoneal soft tissue sarcoma and 13 by recurrent retroperitoneal soft tissue sarcoma) underwent surgical exploration, twenty-three patients had grossly and microscopically complete resection (3 having grossly incomplete resection and the two patients with grossly complete resection have histologically involved resection margin).

Twenty-one out of 28 patients (75 %) underwent removal of contiguous intra-abdominal organs.

Peroperative mortality was nil, and morbidity occurred in six cases only (21 %).

High tumor grade results a significant variable for worse survival in all 28 patients (100 % 3 years survival for low grade versus 0 % for high grade, P = 0.004).

Amongst completely resected patients only histologic grade and peroperative blood transfusion affected disease free survival (P = 0.04 and P = 0.05 respectively).

In conclusion, an aggressive surgical approach in both primary and recurrent RPS is associated with long-term survival.