Publication:
Surgical Technology International XVI - General Surgery
Article title:
Aggressive Surgical Treatment
of Retroperitoneal Sarcoma:
Long-Term Experience of
a Single Institution
Author(s)
Darja Erzen, M.D., M.Sc.
Department of Surgical Oncology
Janez Novak, M.D.
Department of Surgical Oncology
Marko Spiler, M.D.
Department of Surgical Oncology
Mojca Sencar, M.D.
Department of Anaesthesiology
Institute of Oncology, Ljubljana, Slovenia
Abstract
Surgery is the main modality in the therapy of retroperitoneal soft-tissue sarcomas (RSTS). A retrospective study was undertaken to evaluate the results of aggressive surgical treatment in a series of patients of primary and recurrent retroperitoneal sarcomas. A review of 166 consecutive patients with RSTS operated on at the Institute of Oncology in Ljubljana from 1975 through 2005 were reviewed. A total of 269 operations were performed on 166 patients. The five- and ten-year survival rates of patients with localized sarcoma were 52% and 38%, respectively. Factors that influenced the survival were distant metastases, tumor grade, and type of resection. The patients with R0 resections had a five-year survival rate of 75% and a ten-year survival rate of 65%; the respective rates for the patients with R1 resections were 25% and 7% (p < 0.00001). When only R0 resection was considered, referral status (primary, residual, recurrent RSTS) influenced survival (p = 0.004). The quality of initial surgery is a crucial prognostic factor to predicting survival in patients with RSTS. Complete surgical resection without microscopic residuum and contamination is likely to offer the best chances for long-term survival. Unless no other treatment modalities are available, aggressive surgery for recurrent sarcoma is recommended.