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

Antonio Chiappa, Emilio Bertani, Gabriella Pravettoni, Andrew Paul Zbar, Diego Foschi, Giuseppe Spinoglio, Bernardo Bonanni, Gianluca Polvani, Federico Ambrogi, Maria Laura Cossu, Carlo Ferrari, Marco Venturino, Cristiano Crosta, Luca Bocciolone, Roberto Biffi

Research output: Contribution to journalArticlepeer-review

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 1 2018

Keywords

  • Chemotherapy
  • Disease-free survival
  • Radiation therapy
  • Retroperitoneal space
  • Sarcoma
  • Surgery

ASJC Scopus subject areas

  • Surgery

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