Retroperitoneal soft tissue sarcoma: prognostic factors and therapeutic approaches.
OBJECTIVE
Retroperitoneal sarcomas are a rare group of malignant soft tissue tumors with a generally poor prognosis. The aim of the study was to assess clinical, pathological and treatment-related factors affecting prognosis in patients with retroperitoneal sarcomas.


METHODS
The hospital records of 73 patients who underwent surgical exploration at our unit for primary retroperitoneal sarcomas between 1984 and 2003 were reviewed. Factors influencing overall and disease-free survival were analyzed for all patients and for those who underwent complete surgical resection.


RESULTS
The complete resectability rate was 69.8% (51/73). Operative mortality and morbidity rates were 2.7% and 21.9%, respectively. For patients who underwent complete resection, the 5-year survival rate was 58.3%, whereas it was 0% in cases of incomplete or no resection (P < 0.001). Local recurrence rate was 37.2%. Incomplete gross surgical resection and microscopic infiltration of margins were the most important independent predictors of a poor prognosis.


CONCLUSIONS
The present study confirmed the importance of an aggressive surgical management for retroperitoneal sarcomas to offer these patients the best chance for long-term survival.
Pacelli
Fabio
F
Department of Surgical Sciences, Digestive Surgery Division, Catholic University School of Medicine, Rome, Italy. fpacelli@rm.unicatt.it
Tortorelli
Antonio Pio
AP
Rosa
Fausto
F
Papa
Valerio
V
Bossola
Maurizio
M
Sanchez
Alejandro Martin
AM
Ferro
Alessandra
A
Menghi
Roberta
R
Covino
Marcello
M
Doglietto
Giovanni Battista
GB
D000704:Analysis of Variance; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome