Prognostic factors for retroperitoneal soft-tissue sarcoma

Abstract EN

Purpose : to evaluate treatment results of retroperitoneal soft-tissue sarcoma using surgery with / without postoperative radiotherapy (RT) and to identify the prognostic factors for overall and disease-free survivals.

Patients and methods : during the period 1998-2000, sixty patients with retroperitoneal sarcoma, presented to the surgical department, National Cancer Institute, Cairo University, were available for analysis.

They were divided into adult and pediatric groups.

Different patients, tumor and treatment-related factors were analyzed for their influence on both overall and disease free survival.

Patients had been observed for a mean period of 21 ± 8 months (ranged from 10 to 38 months).

Results : there were 41 adults (27 male and 14 female with mean age 52 ± 16 years) and 19 patients in the pediatric group (8 male and 11 female with mean age 5 ± 4 years).

Presentation was primary 71 % and 84 % of the 2 groups, respectively.

In the whole group, 27 patients (45 %) had tumors < 20 cm in its maximum dimension.

Sixty percent (36 patients) had low-grade lesions.

Complete gross resection was achieved in 40 patients (67 %), while the other 20 (33 %) patients couldn’t be completely resected.

Visceral resection was performed in 28 patients, 50 % of them (14 patients) had gross residual left at the tumor bed.

Forty-three patients (72 %) experienced local relapse, 17 of them had distant metastases as well.

The 18-month overall survival was 67 % and the 18-month disease-free survival (DFS) was 38 %.

Female gender, age < 50 years, primary tumor, size < 20 cm, low-grade lesions, gross resection and adjuvant postoperative radiotherapy, all affected both DFS and overall survival significantly.

Pathological subtypes and adjuvant chemotherapy did not show similar effects.

Conclusion : complete surgical resection, with adjuvant radiotherapy are essential for local control which is the main objective in the management of retroperitoneal soft-tissue sarcoma.