Retroperitoneal Sarcomas and Their Management

Constantine P. Karakousis, MD, PhD; Robert Gerstenbluth; Konstantinos Kontzoglou, MD; Deborah L. Driscoll
Arch Surg. 1995;130(10):1104-1109. doi:10.1001/archsurg.1995.01430100082016.
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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 initally 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.(Arch Surg. 1995;130:1104-1109)


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