Surgical role, prognostic factors, and outcome prediction in primary retroperitoneal sarcoma: a prospective large cohort study

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Abstract

Background
Surgical resection with wide safety margins in addition to chemotherapy and radiotherapy has been considered now the best management strategy of retroperitoneal sarcomas (RPS) in case of absence of distant metastasis, but the rate of local recurrence is still high, which worsens patients’ outcome. The aim of this study was to detect postoperative short-term and long-term oncological outcomes of RPS, in addition to evaluating predictive factors related to recurrence, overall survival (OS), and disease-free survival rates in patients with RPS, to allow detection of patients who might have more benefits from aggressive therapeutic approaches and radical surgery.
Patients and methods
This was a prospective study of 80 patients with primary RPS who underwent curative resection. We followed up all patients for about 5 years with recording of all surgical and oncological details.
Results
After a median follow-up time of 34 months, with range 8–56 months, we showed that factors associated with poor OS and recurrence-free survival (RFS) rates in univariate analysis were tumor size, histopathological types, grade, stage, resection margins, adjacent organ infiltration, chemotherapy, radiotherapy (<0.001), and vascular involvement (=0.003). In multivariate analysis, grade (=0.001) and vascular involvement (0.002) were the most important predictors.
Conclusion
We concluded that surgical excision with negative safety margins leads to reduction in local and distant recurrence and favorable RFS and OS rates. Grade, resection margins, and vascular involvement were predictors of RFS and OS rates.

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