Long-term prognosis of primary retroperitoneal soft tissue sarcoma☆,☆☆
Introduction
Treatment of retroperitoneal soft tissue sarcomas (RSTS) is difficult. Adequate tumour-free margins are not easily obtained and locoregional recurrence is common following surgery for retroperitoneal soft tissue sarcomas (RSTS).1 To improve locoregional control, various authors advocate extensive surgery,2, 3 or suggest the (neo-) adjuvant use of chemo- and radiotherapy.4, 5, 6
Data on outcome of patients with RSTS and the efficacy of the proposed aggressive treatment strategies are difficult to interpret. RSTS are rare tumours, controlled data are scarce and mainly come from tertiary referral centres, and follow-up is usually limited.
In a population-based study in the Netherlands we aimed to elucidate the “natural” course of the disease by evaluating the long-term effect of various clinicopathological factors on the result of surgery and outcome.
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Data collection
Information about patients was obtained with help of the Dutch Network and National Database for Pathology (PALGA). All patients that were registered in the Netherlands between 1989 and 1994 as having a newly diagnosed primary RSTS were selected by this registry (n = 301). In 1995, a questionnaire about the histopathology of the tumour (histological type, malignancy grade) was sent to the involved pathology laboratories (n = 58). The questionnaire was accompanied by a request for the original
Clinicopathological data
There were 79 females (55%) and 64 males, with a median age of 60 (range 18–88) years. The distribution of the clinicopathological factors is shown in Table 1. Liposarcomas and leiomyosarcomas prevailed and together comprised two-thirds of all tumours. Other histomorphological sarcoma types were sarcoma no otherwise specified (n = 18), malignant fibrous histiocytoma (n = 10), malignant peripheral nerve sheat tumour (n = 5), fibrosarcoma (n = 4). The remaining 10 patients had other sarcomas, and four of
Discussion
In the present population-based study in patients with retroperitoneal soft tissue sarcoma overall survival declined throughout the 10 year observation period. After 10 years, only 20% of the patients were alive and one fifth of the latter patients had recurrent disease. Malignancy grade had an impact on overall survival as well as on the success of surgical treatment.
References (21)
- et al.
Resectability of retroperitoneal sarcomas: a matter of surgical technique?
Eur J Surg Oncol
(1995) - et al.
High-dose-rate intraoperative radiation therapy (HDR-IORT) for retroperitoneal sarcomas
Int J Radiat Oncol Biol Phys
(2000) - et al.
Is there a role for incomplete resection in the management of retroperitoneal liposarcomas?
J Am Coll Surg
(2001) - et al.
Locoregional recurrence of retroperitoneal soft tissue sarcoma: second chance of cure for selected patients
Eur J Surg Oncol
(2001) - et al.
Long-term results of intraoperative electron beam radiotherapy for primary and recurrent retroperitoneal soft tissue sarcoma
Int J Radiat Oncol Biol Phys
(2001) - et al.
Surgical resection and radiotherapy for primary retroperitoneal soft tissue sarcoma
Radiother Oncol
(2002) - et al.
Retroperitoneal soft tissue sarcomas: patterns of recurrence in 167 patients treated at a single institution
Cancer
(2004) - et al.
Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution
Ann Surg
(1998) - et al.
Phase I trial of preoperative concurrent doxorubicin and radiation therapy, surgical resection, and intraoperative electron-beam radiation therapy for patients with localized retroperitoneal sarcoma
J Clin Oncol
(2003) Early postoperative intraperitoneal adriamycin as an adjuvant treatment for visceral and retroperitoneal sarcoma
Cancer Treat Res
(1996)
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Presented to a meeting of the British Association of Surgical Oncology, London, UK, November 2004 and published in abstract form as Eur J Surg Oncol 2004;30:1016.
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No financial support was received for this study.