title: Perioperative outcome in sarcoma surgery.
abstract: BACKGROUND
  Soft tissue sarcomas (STS) are rare tumors accounting for less than 1% of all malignancies. Although disease-specific surgical management is increasingly important, only few data are available for STS. Here, we analyze a single institution setting focusing on perioperative surgical and clinical parameters.
  
  
  METHODS
  Prospectively gathered data of all adult patients undergoing surgery for STS including gastrointestinal stroma tumors (GIST) between October 2001 and October 2004. Patients undergoing only biopsy or ambulatory surgery were excluded. Statistical analysis was performed using SAS(R) software and patient's data from a computerized sarcoma registry.
  
  
  RESULTS
  159 patients with a median age of 60.2 years underwent a total of 179 operations. Three major sites of occurrence were notified: the visceral cavity (VIS) (36.3%), the retroperitoneum (RET) (31.3%), and the extremities (EXT) (27.4%). GIST (53.9%) were the most common type in the VIS, liposarcoma (62.5%) in the RET, and either liposarcoma (30.6%) or malignant fibrous histiocytoma (28.6%) in the EXT. Recurrence was treated in more than half of the patients with RET STS, and in almost one third of the EXT lesions, while primary occurrence dominated in the VIS. Median operation times in the VIS, RET, and EXT were 210, 240, and 120 min, respectively. Blood loss was 300, 500, and 50 ml for VIS, RET, and EXT operations. Morbidity was 26.2, 30.4, and 34.7% in VIS, RET, and EXT operations, respectively (reoperation rates were 9.4, 5.4, and 14.3%). Mortality was 1.5, 8.9, and 2.0% for VIS, RET, and EXT. Length of hospital stay in the groups was comparable.
  
  
  CONCLUSIONS
  STS surgery of a single surgical unit contains predominantly VIS, RET, and EXT tumors. The STS subtype varies with location, as does length of operation, blood loss, morbidity, mortality, and reoperation rate. These data are helpful for planning the perioperative management of adult patients with STS and can be used for prognostic analyses.
authors.affiliation: Department of General, Visceral and Trauma Surgery, University of Heidelberg, Heidelberg, Germany.
authors.forename: Moritz N
authors.initials: MN
authors.lastname: Wente
authors.forename: Matthias H M
authors.initials: MH
authors.lastname: Schwarzbach
authors.forename: Ulf
authors.initials: U
authors.lastname: Hinz
authors.forename: Christine
authors.initials: C
authors.lastname: Leowardi
authors.forename: Gunhild
authors.initials: G
authors.lastname: Mechtersheimer
authors.forename: Robert
authors.initials: R
authors.lastname: Krempien
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Egerer
authors.forename: Helmut
authors.initials: H
authors.lastname: Friess
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D005121:Extremities; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery; D051677:Histiocytoma, Malignant Fibrous / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D007902:Length of Stay; D008080:Liposarcoma / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018317:Nerve Sheath Neoplasms / Q000601:surgery; D019990:Perioperative Care; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000601:surgery*; D012509:Sarcoma / Q000601:surgery*; D016896:Treatment Outcome; D014781:Viscera