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Aggressive Surgery in Retroperitoneal Soft Tissue Sarcoma Carried Out at High-Volume Centers is Safe and is Associated With Improved Local Control

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

We sought to assess morbidity and mortality in primary retroperitoneal soft tissue sarcomas (RSTS) treated by a frontline aggressive surgical approach.

Methods

A total of 249 consecutive patients with primary RSTS were treated by a frontline aggressive surgical approach at two major European institutions. Multivariable models were used for exploring the relationship between postsurgical morbidity and the number of organs resected, with adjustment for clinical variables. The impact of morbidity on local and distant recurrence-free survival was explored by multivariable models, adjusting for the main known prognostic factors.

Results

Median follow-up was 37 months (interquartile [IQ] range, 16–61 months). Median tumor size was 17 cm (IQ range, 11–26 cm). The median number of organs resected en bloc with the tumor was 2 (IQ range, 1–3). Complete macroscopic resection was achieved in 232 cases (93%). At 5 years, overall survival was 65.4% (95% confidence interval [95% CI], 56.8–72.7); local and distant recurrence crude cumulative incidences were 22.3% (95% CI, 16.5–30.2) and 24.2% (95% CI, 18.4–31.9), respectively. Postsurgical morbidity requiring at least one invasive therapeutic procedure was observed in 45 patients (18%; 95% CI, 14–23). Surgical reintervention was necessary in 30 patients (12%; 95% CI, 8–17). Eight patients died of postoperative complications (3%; 95% CI, 1–6). No statistically significant association between postsurgical morbidity and any clinical variable was detected. For number of resected organs, we documented an increased risk of morbidity for more than three organs (P = 0.007). Postsurgical morbidity did not affect oncologic outcome.

Conclusions

Frontline aggressive surgical approach to primary RSTS is safe when carried out at high-volume centers. It could be systematically considered in primary RSTS.

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Authors and Affiliations

  1. Department of Surgery, Institut Gustave Roussy, Villejuif, France

    Sylvie Bonvalot MD, PhD, Sylvain Causeret MD & Hatem Bouzaiene MD

  2. Department of Biostatistics, Istituto Nazionale Tumori, Milan, Italy

    Rosalba Miceli PhD & Luigi Mariani MD

  3. Department of Surgery, Istituto Nazionale Tumori, Milan, Italy

    Mattia Berselli MD, Chiara Colombo MD, Marco Fiore MD & Alessandro Gronchi MD

  4. Department of Radiotherapy, Institut Gustave Roussy, Villejuif, France

    Cécile Le Péchoux MD

  5. Department of Cancer Medicine, Istituto Nazionale Tumori, Milan, Italy

    Paolo Giovanni Casali MD

  6. Department of Cancer Medicine, Institut Gustave Roussy, Villejuif, France

    Axel Le Cesne MD

Authors
  1. Sylvie Bonvalot MD, PhD
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  2. Rosalba Miceli PhD
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  3. Mattia Berselli MD
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  4. Sylvain Causeret MD
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  5. Chiara Colombo MD
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  6. Luigi Mariani MD
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  7. Hatem Bouzaiene MD
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  8. Cécile Le Péchoux MD
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  9. Paolo Giovanni Casali MD
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  10. Axel Le Cesne MD
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  11. Marco Fiore MD
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  12. Alessandro Gronchi MD
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Corresponding author

Correspondence to Alessandro Gronchi MD.

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Bonvalot, S., Miceli, R., Berselli, M. et al. Aggressive Surgery in Retroperitoneal Soft Tissue Sarcoma Carried Out at High-Volume Centers is Safe and is Associated With Improved Local Control. Ann Surg Oncol 17, 1507–1514 (2010). https://doi.org/10.1245/s10434-010-1057-5

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  • DOI: https://doi.org/10.1245/s10434-010-1057-5

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