Locoregional recurrence of retroperitoneal soft tissue sarcoma:second chance of cure for selected patients

Background: Locoregional recurrence of a retroperitoneal soft tissue sarcoma (RSTS) may offer a second chance of curative surgical treatment. In a population-based study the proportion of patients developing isolated locoregional recurrences (LR) was determined and the outcome of these patients was analysed. Method: In a retrospective nationwide study, data were collected on 142 patients treated between I January 1989 and I January 1994 for primary RSTS. In patients who had been treated radically for their primary sarcoma (77/142, 54%), the pattern of recurrence was evaluated. Factors predictive of survival for patients with LR were studied. Results: After a median follow-up of 86 (range 60-101) months, 32 patients (42%) had developed LR, and distant metastasis (DM) had been diagnosed in 17 patients (22%). Median disease-free interval between the initial operation and the establishment of LR or DM was 22 and 19 months, respectively. Five-year cumulative survival of patients with established LR was 37% in comparison with 11% for patients with DM (P=0.062). Factors predictive of favourable outcome in patients with LR were the absence of multifocal recurrence (n = 13; P = 0.01), lipomatous histomorphology (n = 20; P = 0.02), and a complete resection of recurrent sarcoma (n = 17; P = 0.04). Conclusion: After a median follow-up of 7 years following radical treatment of a primary RSTS, 42% of the patients had developed isolated locoregional recurrences. A complete resection of recurrent disease, lipomatous histomorphology and the absence of multifocal growth influenced prognosis favourably. (C) 2001 Harcourt Publishers Ltd

Long-term prognosis of primary retroperitoneal soft tissue sarcoma.

Contains fulltext : 51614.pdf (publisher's version ) (Closed access)AIMS: To evaluate the result of treatment and long-term outcome of a population-based cohort of patients with retroperitoneal soft tissue sarcoma (RSTS). METHODS: Between 1 January 1989 and 1 January 1994, 143 patients diagnosed as having primary RSTS were selected from a national pathology database (PALGA) in the Netherlands. In this population-based group of patients, the result of surgery, overall survival (OS) and disease-free survival (DFS) were analysed as well as factors affecting OS and DFS. Median follow-up was 10.2 years. RESULTS: Operative treatment resulted in a complete tumour resection in 55% of the patients (n=78), low- and intermediate-grade tumours were more often completely resected than high-grade tumours (P=0.016). Five- and 10-year cumulative OS was 39% and 21%, respectively, while DFS was 22% and 17%, respectively. In a multivariate analysis low malignancy grade (P=0.017) and a complete tumour resection (P<0.001) were associated with better OS. CONCLUSIONS: Complete tumour resection and low malignancy grade were independent favourable prognosticators. However, these factors were related too, since surgical success was influenced by malignancy grade

Soft tissue sarcoma in the retroperitoneum: an often neglected diagnosis

Aims: Successful surgical treatment of patients with retroperitoneal soft tissue sarcoma (RSTS) is based on preoperative planning that starts with a correct pre-operative diagnosis. In a population-based study, we determined which patients were initially treated for assumed other conditions. The effect of an erroneous diagnosis on the installed treatment was analysed. Method: With the help of the Dutch Network and National Database for Pathology (PALGA), data were collected on 143 patients in the Netherlands in whom a primary RSTS was found and confirmed histologically between I January 1989 and 1 January 1994. Satisfactory clinical information was obtained on 138 patients, 64 males and 74 females (54%). The median age was 60 (range 18-88) years. Results: At the time of actual treatment 37% of the patients with RSTS were assumed to have another disorder (group I; n=51), whereas 87 patients were diagnosed as having RSTS (group 2). In group I, an acute presentation was more common (18 vs 2%; P=0.002), and the tumour was less often palpable at physical examination (43 vs 69%; P=0.004), while clinical work-up less frequently included CT-imaging (57 vs 89%; P Conclusions: (1) More than one-third of patients with RSTS are misdiagnosed and inappropriately treated; and (2) biopsies and cross-sectional imaging improve diagnosis. (C) 2001 Harcourt Publishers Ltd