Retroperitoneal soft tissue sarcomas: patterns of recurrence in 167 patients treated at a single institution.
BACKGROUND
The 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.


METHODS
Overall, 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%).


RESULTS
Overall 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.


CONCLUSIONS
Local 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.
Gronchi
Alessandro
A
Department of Surgery, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy. alessandro.gronchi@istitutotumori.mi.it
Casali
Paolo G
PG
Fiore
Marco
M
Mariani
Luigi
L
Lo Vullo
Salvatore
S
Bertulli
Rossella
R
Colecchia
Maurizio
M
Lozza
Laura
L
Olmi
Patrizia
P
Santinami
Mario
M
Rosai
Juan
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D017211:Treatment Failure