Retroperitoneal sarcomas and their management

C. P. Karakousis, R. Gerstenbluth, K. Kontzoglou and D. L. Driscoll
Department of Surgery, State University of New York at Buffalo, Millard Fillmore Hospital, USA.

BACKGROUND: Retroperitoneal sarcomas historically have presented difficulties in their management due to a high rate of unresectability. OBJECTIVE: To determine prognostic parameters, resectability, and survival of these patients in a more recent period. DESIGN: Retrospective review, with a mean follow-up of 47 months. SETTING: Tertiary care cancer institute. PATIENTS: The charts of 90 consecutive patients with retroperitoneal sarcomas treated in the period from 1977 to 1995. No patient referred with a localized retroperitoneal sarcoma was excluded from this review. RESULTS: The resectability rate was 100% for the primary tumors (n = 57) and 88% for the tumors initially presenting as local recurrence (n = 33). The 5-year survival rate was 63% (66% for patients with primary tumors and 57% for those with local recurrence). The 10-year survival rate was 46% (57% for patients with primary tumors and 26% for those referred with local recurrence). The local recurrence rate was 25% for primary tumors and 39% for tumors initially presented as local recurrence (overall rate, 30%); it was 56% after local excision and 16% after wide or radical resection (P < .001). The 5- and 10-year survival rates were 72% and 61%, respectively, for those with wide resection and 55% and 23%, respectively, for those with local excision (P = .01). CONCLUSIONS: With modern surgical techniques, the overall resectability rate of retroperitoneal sarcomas is 96%. The ensuing survival, affected significantly by the histologic grade, approaches that for the extremity sarcomas.

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