Background. Retroperitoneal sarcomas are malignant tumors with an aggressive course of disease. Cause of death is local disease in 50% and disseminated disease in only 25%. We made a retrospective ...analysis of surgical treatment of retroperitoneal sarcomas in order assess the effect of this treatment modality on the course of the disease.In the years between 1975 and 2000, 155 patients were surgically treated for primary retroperotneal sarcoma at the Institute of Oncology in Ljubljana. Only 81 of 155 patients received the first treatment at our Institute, while other patients had been at least once operated on elsewhere before the admission to our Institute. Of these patients, 40 required a second surgery for the residual disease and 31 for recurrence. In 23 patients, metastatic spread was found at diagnosis. Our treatment approach was aggressive. We surgically removed the recurrent sarcomas and metastases wherever accessible. Operability at the first surgical treatment performed at the Institute of Oncology was 92%. Therefore, 44 patients underwent 3 or more surgeries for sarcoma. The highest number of operations performed in one patients was 9 (2 patients). In 127 patients, the tumor block resection involved at least one additional organ (up to 6).Results. Complications were not sparse; perioperative mortality was 8.4%. The survival depended upon the metastatic spread at diagnosis, tumor grade and oncologic surgery type.Conclusions. Despite complications, only complete resection without microscopic resuduum and contamination yields a long-term survival to the patients with retroperitoneal sarcoma.
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.
