title: Significant benefits in survival by the use of surgery combined with radiotherapy for retroperitoneal soft tissue sarcoma.
abstract: BACKGROUND
  To report the effect of intraoperative electron beam radiotherapy (IOERT) and external beam radiotherapy (EBRT) in addition to surgery as well as to evaluate the role of resectable local recurrence for long-term prognosis.
  
  
  METHODS
  In 53 patients who underwent surgery for retroperitoneal soft tissue sarcoma (RSTS) from 2001 to 2014 prognostic and epidemiologic factors were reviewed retrospectively to analyze their impact on survival and recurrence.
  
  
  RESULTS
  Twenty three patients (50%) had surgery plus radiotherapy, 23 (50%) had surgery only. Histology showed 73.9% liposarcoma, 15.2% leiomyosarcoma and 6.5% pleomorphic undifferentiated sarcoma respectively. Low grade sarcoma were observed in 52.2%, high grade sarcoma in 47.8%. The latter showed a trend towards a decreased 5-year survival rate (p = 0.125). Margin status was: R0: 60.9%, R1: 23.9%, R2: 15.2%; leading to significant changes in 5-year survival rate (R0: 77.6%; R1: 70.0%; R2: 42.9%; p = 0.03). Age younger than 55 years significantly improved 5-year survival rate (p = 0.039). Patients receiving resection of multiple sarcoma recurrence showed an almost identical improved 5-year survival rate compared to patients without recurrence (no recurrence: 100.0%; single recurrence: 35.0%; multiple recurrence: 91.7%; p = 0.001). Surgery plus radiotherapy led to significantly improved survival (p = 0.04).
  
  
  CONCLUSIONS
  There is a significant benefit in terms of 5-year survival after surgery plus some form of radiotherapy and a good prognosis for patients when the recurrence from RSTS was resected. Age older than 55 years and incomplete resection lowered 5-year survival rate significantly.
authors.affiliation: Department of General- and Visceral Surgery, Universitätsklinik Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Hager
authors.affiliation: Department of General- and Visceral Surgery, Universitätsklinik Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Makowiec
authors.affiliation: Department of Radiation Oncology, Universitätsklinik Freiburg, Hugstetter Str. 55, Freiburg, 79106, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Henne
authors.affiliation: Department of General- and Visceral Surgery, Universitätsklinik Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
authors.forename: Ulrich T
authors.initials: UT
authors.lastname: Hopt
authors.affiliation: Department of General- and Visceral Surgery, Universitätsklinik Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. uwe.wittel@uniklinik-freiburg.de.
authors.forename: Uwe A
authors.initials: UA
authors.lastname: Wittel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D011879:Radiotherapy Dosage; D012186:Retroperitoneal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015996:Survival Rate
keywords: Radiation therapy; Radiotherapy; Recurrence; Retroperitoneal soft tissue sarcoma; Surgery