title: Challenges in the Surgical Treatment of Retroperitoneal Sarcomas.
abstract: The objective of this study is to assess long-term prognosis and patterns of failure in patients with retroperitoneal sarcoma who underwent surgery with curative intent at a single institution. We also provide a thorough review of the literature including several series and widely variable data regarding local and distant failure. During a 25-year period (1988-2013), 45 consecutive patients who underwent surgery for retroperitoneal sarcoma at a single referral center were reviewed retrospectively. We recorded and analyzed the presenting symptoms, type of surgical excision, and the 5-year survival rate as well as the local recurrence rate of patients with complete tumor resection. Overall survival is significantly diminished in patients in whom resection margins are not adequate. In our series, 5-year recurrence rate for patients with complete and incomplete resection of the tumor was 30.76 and 68.42 %, respectively. The 5-year survival rate was 51.12 %, and the 5-year survival rate according to type of resection was 76.93 % for complete and 15.79 % for incomplete resections. Local recurrence after first surgery and high-grade malignancy are associated with poor survival. The role of radiation therapy and chemotherapy in the treatment of retroperitoneal sarcoma (RPS) should be investigated further. Complete en bloc resection of the tumor mass and adjacent structures is the single most important factor that improves survival.
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens, Medical School, "Laikon" General Hospital, Agiou Thoma 17, Goudi, 11527 Athens, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Konofaos
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens, Medical School, "Laikon" General Hospital, Agiou Thoma 17, Goudi, 11527 Athens, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Spartalis
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens, Medical School, "Laikon" General Hospital, Agiou Thoma 17, Goudi, 11527 Athens, Greece ; Anastasiou Gennadiou 56, 11474 Athens, Greece.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Moris
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens, Medical School, "Laikon" General Hospital, Agiou Thoma 17, Goudi, 11527 Athens, Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Athanasiou
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens, Medical School, "Laikon" General Hospital, Agiou Thoma 17, Goudi, 11527 Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Dimitroulis
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens, Medical School, "Laikon" General Hospital, Agiou Thoma 17, Goudi, 11527 Athens, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Markakis
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens, Medical School, "Laikon" General Hospital, Agiou Thoma 17, Goudi, 11527 Athens, Greece.
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Kostakis
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens, Medical School, "Laikon" General Hospital, Agiou Thoma 17, Goudi, 11527 Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Nikiteas
authors.affiliation: 2nd Department of Propedeutic Surgery, University of Athens, Medical School, "Laikon" General Hospital, Agiou Thoma 17, Goudi, 11527 Athens, Greece.
authors.forename: Gregory
authors.initials: G
authors.lastname: Kouraklis
keywords: Adjuvant therapy; Recurrence; Retroperitoneal sarcoma; Surgical excision