Retroperitoneal Liposarcoma: Treatment Outcome in Primary and Secondary Surgical Intervention

Background Approximately 30% to 40% of all retroperitoneal soft tissue tumors are sarcomas, with liposarcoma prevailing in approximately 50% of these cases. Retroperitoneal liposarcomas typically show a high rate of local recurrence and late distant metastases. The aim of our retrospective analysis was to investigate the efficacy of treatment in our patients with liposarcoma. Methods Thirty-four consecutive patients underwent surgery in our clinic between October 2004 and November 2017. Liposarcomas arising from the mesenteric or abdominal adipose tissue or the pelvis were excluded. Results Of 34 patients, 23 (67.6%) presented with primary and 11 (32.4%) with recurrent disease. In 7 of the 34 patients (20.6%), a radical resection (R0) could be achieved, and in 27 patients (76.5%) resection was marginal (R1). Time to recurrence was not affected by neoadjuvant radiotherapy. Patients who underwent systemic chemotherapy followed by radiotherapy developed earlier recurrences (P = 0.003) than patients with neoadjuvant radiotherapy only. Overall survival was significantly better in the neoadjuvant group (P 0.045) Conclusions Combining surgical resection with neoadjuvant radiation treatment showed survival benefits in primary but not recurrent disease. Repeated surgery remains a valid approach in carefully selected patients, but all patients should be referred to a center of expertise in multimodal treatment approaches for retroperitoneal liposarcomas.