Long-term results of primary and secondary resections in patients with retroperitoneal soft tissue sarcoma

The aim of this study was to analyse treatment and long-term outcome for primary and recurrent disease in patients with retroperitoneal soft tissue sarcoma (RSTS). Clinicopathological data including tumour stage, grade, and histological subtype, location of the principal tumour, completeness of resection and operative procedure were studied. Kaplan-Meier estimations and Cox regression analyses were performed. Patients comprised a primary resection group (PRG, n = 42), and a secondary resection group (SRG, n = 12) which included patients with recurrent RSTS and/or metastatic RSTS. Postoperative complications occurred in 15 patients (PRG: n = 13 (31%); SRG: n = 2, (16.7%)) and overall 30-day mortality was 5.6% (PRG: n = 2 (4.8%); SRG: n = 1 (8.3%)). Median overall survival was 58 months (PRG 60 months, SRG 50 months) with a 5-year survival rate of 39% (PRG 35.7%, SRG 50%) and a 1-year survival of 74.1% (PRG 71.4%, SRG 83.3%). Multivariate Cox regression analyses indicated that histopathological subtype (P = 0.006), completeness of resection (P < 0.001) and tumour grade (P = 0.018) were independent prognostic variables for overall survival. In the absence of effective alternative treatment options, patients with RSTS should undergo extended resection, even in recurrent disease. Complete surgical resection is still the most effective modality for the treatment of retroperitoneal sarcoma.