title: Treatment of locally recurrent soft tissue sarcomas of the retroperitoneum: report of 30 cases.
abstract: To assess the results in treating locally recurrent soft tissue sarcomas of the retroperitoneum, we reviewed the clinical, therapeutic, and pathologic characteristics of 30 patients who underwent surgical exploration. Complete resection was achieved in 18 patients (60%), 6 with en bloc resection of adjacent organs involved by the tumors. Following the first operation for recurrent lesions, the median survival was 33 months for those undergoing complete resection and 14 months for those undergoing partial resection or biopsy (P = 0.04). Patients with a disease-free interval (DFI) of > 24 months were associated with better prognosis than those with DFI of < or = 24 months (median survival: 40 months vs. 17 months, P = 0.03). Patients with tumor size of < or = 20 cm had longer survival than those with tumor size of > 20 cm (median survival: 39 months vs. 23 months, P = 0.04). Among 14 patients who received adjuvant radiation therapy, four patients whose tumors had been considered unresectable at first exploration for recurrence underwent complete resection after preoperative radiation therapy. An aggressive surgery aimed at complete resection in treating recurrent retroperitoneal sarcomas is strongly recommended. We suggest that in large tumors preoperative radiation therapy should be used to reduce the tumor volume and therefore a higher rate of complete resection may be achieved.
authors.affiliation: Department of Surgery, Cancer Hospital, Shanghai Medical University, China.
authors.forename: Y N
authors.initials: YN
authors.lastname: Wang
authors.forename: W Q
authors.initials: WQ
authors.lastname: Zhu
authors.forename: Z Z
authors.initials: ZZ
authors.lastname: Shen
authors.forename: S
authors.initials: S
authors.lastname: Li
authors.forename: S Y
authors.initials: SY
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D012086:Reoperation; D012186:Retroperitoneal Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D012509:Sarcoma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome