Aggressive Surgical Approach for Treatment of Primary and Recurrent Retroperitoneal Soft Tissue Sarcoma

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Abstract

To analyze treatment and survival in a series of resected patients with primary or recurrent retroperitoneal sarcoma (RPS) treated and prospectively followed at a single institution. Between July 1994 and December 2015, 89 patients (36 M, 53 F; mean age 60 years, range 25-79) were evaluated. For the purpose of analysis, complete resection was defined as removal of gross tumor with histologically confirmed clear resection margins. Eighty-three out of the 89 patients (93%), 46 of whom affected by primary RPS, and 37 by recurrent RPS, underwent surgical exploration. Sixty-two had a grossly and microscopically complete resection. Fifty-three out of 83 patients (64%) underwent removal of contiguous intra-abdominal organs. Preoperative mortality was nil and significant preoperative complications occurred in six cases only (7%). High-grade tumor pointed out to be a significant variable for a worse survival in all 83 patients amenable to undergo surgical resection (57% 5 years survival for low grade vs 14% for high grade; P = 0.0004). Among completely resected patients, only histologic grade clearly affected disease-free survival (72% 5 years survival for low grade vs 50% for high grade; P = 0.04), while the role of preoperative blood transfusions (67% 5 years survival for non-transfused patients vs 29% for transfused patients; P = 0.05) has to be evaluated in connection to patient complexity. Histological grade and recurrence are the most valuable prognostic predictors; in this clinical subset, an aggressive surgical approach in both primary and recurrent RPS is associated with a best long-term survival and disease-free survival.

Original languageEnglish
Pages (from-to)154-162
Number of pages9
JournalIndian Journal of Surgery
Volume80
Issue number2
DOIs
Publication statusPublished - Apr 2018

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Sarcoma
Survival
Therapeutics
Disease-Free Survival
Sarcoma 37
Survival Analysis
Blood Transfusion
Neoplasms
Recurrence
Mortality

Cite this

@article{934bc6ea08d24445a736eb1c433a1d63,
title = "Aggressive Surgical Approach for Treatment of Primary and Recurrent Retroperitoneal Soft Tissue Sarcoma",
abstract = "To analyze treatment and survival in a series of resected patients with primary or recurrent retroperitoneal sarcoma (RPS) treated and prospectively followed at a single institution. Between July 1994 and December 2015, 89 patients (36 M, 53 F; mean age 60 years, range 25-79) were evaluated. For the purpose of analysis, complete resection was defined as removal of gross tumor with histologically confirmed clear resection margins. Eighty-three out of the 89 patients (93{\%}), 46 of whom affected by primary RPS, and 37 by recurrent RPS, underwent surgical exploration. Sixty-two had a grossly and microscopically complete resection. Fifty-three out of 83 patients (64{\%}) underwent removal of contiguous intra-abdominal organs. Preoperative mortality was nil and significant preoperative complications occurred in six cases only (7{\%}). High-grade tumor pointed out to be a significant variable for a worse survival in all 83 patients amenable to undergo surgical resection (57{\%} 5 years survival for low grade vs 14{\%} for high grade; P = 0.0004). Among completely resected patients, only histologic grade clearly affected disease-free survival (72{\%} 5 years survival for low grade vs 50{\%} for high grade; P = 0.04), while the role of preoperative blood transfusions (67{\%} 5 years survival for non-transfused patients vs 29{\%} for transfused patients; P = 0.05) has to be evaluated in connection to patient complexity. Histological grade and recurrence are the most valuable prognostic predictors; in this clinical subset, an aggressive surgical approach in both primary and recurrent RPS is associated with a best long-term survival and disease-free survival.",
author = "Antonio Chiappa and Emilio Bertani and Gabriella Pravettoni and Zbar, {Andrew Paul} and Diego Foschi and Giuseppe Spinoglio and Bernardo Bonanni and Gianluca Polvani and Federico Ambrogi and Cossu, {Maria Laura} and Carlo Ferrari and Marco Venturino and Cristiano Crosta and Luca Bocciolone and Roberto Biffi",
year = "2018",
month = "4",
doi = "10.1007/s12262-018-1722-7",
language = "English",
volume = "80",
pages = "154--162",
journal = "Indian Journal of Surgery",
issn = "0019-5650",
publisher = "Scientific Publishers of India",
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TY - JOUR

T1 - Aggressive Surgical Approach for Treatment of Primary and Recurrent Retroperitoneal Soft Tissue Sarcoma

AU - Chiappa, Antonio

AU - Bertani, Emilio

AU - Pravettoni, Gabriella

AU - Zbar, Andrew Paul

AU - Foschi, Diego

AU - Spinoglio, Giuseppe

AU - Bonanni, Bernardo

AU - Polvani, Gianluca

AU - Ambrogi, Federico

AU - Cossu, Maria Laura

AU - Ferrari, Carlo

AU - Venturino, Marco

AU - Crosta, Cristiano

AU - Bocciolone, Luca

AU - Biffi, Roberto

PY - 2018/4

Y1 - 2018/4

N2 - To analyze treatment and survival in a series of resected patients with primary or recurrent retroperitoneal sarcoma (RPS) treated and prospectively followed at a single institution. Between July 1994 and December 2015, 89 patients (36 M, 53 F; mean age 60 years, range 25-79) were evaluated. For the purpose of analysis, complete resection was defined as removal of gross tumor with histologically confirmed clear resection margins. Eighty-three out of the 89 patients (93%), 46 of whom affected by primary RPS, and 37 by recurrent RPS, underwent surgical exploration. Sixty-two had a grossly and microscopically complete resection. Fifty-three out of 83 patients (64%) underwent removal of contiguous intra-abdominal organs. Preoperative mortality was nil and significant preoperative complications occurred in six cases only (7%). High-grade tumor pointed out to be a significant variable for a worse survival in all 83 patients amenable to undergo surgical resection (57% 5 years survival for low grade vs 14% for high grade; P = 0.0004). Among completely resected patients, only histologic grade clearly affected disease-free survival (72% 5 years survival for low grade vs 50% for high grade; P = 0.04), while the role of preoperative blood transfusions (67% 5 years survival for non-transfused patients vs 29% for transfused patients; P = 0.05) has to be evaluated in connection to patient complexity. Histological grade and recurrence are the most valuable prognostic predictors; in this clinical subset, an aggressive surgical approach in both primary and recurrent RPS is associated with a best long-term survival and disease-free survival.

AB - To analyze treatment and survival in a series of resected patients with primary or recurrent retroperitoneal sarcoma (RPS) treated and prospectively followed at a single institution. Between July 1994 and December 2015, 89 patients (36 M, 53 F; mean age 60 years, range 25-79) were evaluated. For the purpose of analysis, complete resection was defined as removal of gross tumor with histologically confirmed clear resection margins. Eighty-three out of the 89 patients (93%), 46 of whom affected by primary RPS, and 37 by recurrent RPS, underwent surgical exploration. Sixty-two had a grossly and microscopically complete resection. Fifty-three out of 83 patients (64%) underwent removal of contiguous intra-abdominal organs. Preoperative mortality was nil and significant preoperative complications occurred in six cases only (7%). High-grade tumor pointed out to be a significant variable for a worse survival in all 83 patients amenable to undergo surgical resection (57% 5 years survival for low grade vs 14% for high grade; P = 0.0004). Among completely resected patients, only histologic grade clearly affected disease-free survival (72% 5 years survival for low grade vs 50% for high grade; P = 0.04), while the role of preoperative blood transfusions (67% 5 years survival for non-transfused patients vs 29% for transfused patients; P = 0.05) has to be evaluated in connection to patient complexity. Histological grade and recurrence are the most valuable prognostic predictors; in this clinical subset, an aggressive surgical approach in both primary and recurrent RPS is associated with a best long-term survival and disease-free survival.

U2 - 10.1007/s12262-018-1722-7

DO - 10.1007/s12262-018-1722-7

M3 - Article

C2 - 29915482

VL - 80

SP - 154

EP - 162

JO - Indian Journal of Surgery

JF - Indian Journal of Surgery

SN - 0019-5650

IS - 2

ER -