title: Comprehensive Surgical Treatment as the Mainstay of Management in Retroperitoneal Sarcomas: Retrospective Study from Two Non-sarcoma Specialist Centers.
abstract: Complete resection, surgical expertise and individualization of patient management in comprehensive oncology centres result in better clinical outcomes in patients presenting with retroperitoneal sarcomas.
  
  
  
  Clinical outcomes of primary and recurrent retroperitoneal sarcoma resections performed between January 2002 and December 2016 in two large surgical oncology, but non-sarcoma specialist centers, were reviewed to determine the efficacy of complete surgical resection as the principle instrument for treatment. The histological type, tumor size and grade, as well as organ resection, were recorded and subsequently reviewed.
  
  
  
  Our study included 108 cases of sarcoma resection (60 first-time, 38 second-time and 10 third-time laparotomies) in 60 patients (35 males and 25 females). Most patients had complete resection: 57 had a macroscopically complete (R0/R1) resection and three had R2 resection. The 90-day mortality rate was zero and morbidity was minimal. Five- and 10-year overall survival (OS) rates were 88% and 79%, respectively, whereas the corresponding disease-free survival (DFS) rates were 65% and 59%, respectively. High-grade tumors were associated with decreased DFS (hazard ratio(HR)=3.35; 95% confidence interval(CI)=1.23-9.10; p=0.018) and decreased OS (HR=7.18; 95% CI=1.50-34.22; p=0.013).
  
  
  
  Complete surgical resection of retroperitoneal sarcomas combined with individualized patient management when offered by experienced surgical oncology teams, adhering to international guidelines, can succeed in providing patients with good long-term outcomes, comparable to those achieved at sarcoma-specialist centers.
authors.affiliation: Hepatobiliary and Surgical Oncology Department, Nicosia Teaching Hospital, Nicosia, Cyprus.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Petrou
authors.affiliation: Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, U.K.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Constantinidou
authors.affiliation: First Department of Surgery, University of Athens Medical School, Laikon General Hospital, Athens, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Kontos
authors.affiliation: First Department of Surgery, University of Athens Medical School, Laikon General Hospital, Athens, Greece.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Papalampros
authors.affiliation: First Department of Surgery, University of Athens Medical School, Laikon General Hospital, Athens, Greece dimmoris@yahoo.com.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Moris
authors.affiliation: First Department of Surgery, University of Athens Medical School, Laikon General Hospital, Athens, Greece.
authors.forename: Chris
authors.initials: C
authors.lastname: Bakoyiannis
authors.affiliation: Hepatobiliary and Surgical Oncology Department, Nicosia Teaching Hospital, Nicosia, Cyprus.
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Neofytou
authors.affiliation: Hepatobiliary and Surgical Oncology Department, Nicosia Teaching Hospital, Nicosia, Cyprus.
authors.forename: George
authors.initials: G
authors.lastname: Kourounis
authors.affiliation: Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, London, U.K.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Felekouras
mesh_terms: D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate
keywords: Retroperitoneal sarcoma; long-term outcome; resection