Retroperitoneal Sarcomas and Their Management

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.