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Long-Term Outcome After Surgery for a Localized Retroperitoneal Soft Tissue Sarcoma in Elderly Patients: Results from a Retrospective, Single-Center Study

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

Abstract

Background

To evaluate short- and long-term results after curative surgery for a retroperitoneal sarcoma (RPS) in elderly patients.

Methods

We retrospectively analyzed data of all patients operated in our single, tertiary care center for a nonmetastatic RPS and identified patients aged 70 years and older.

Results

Among 296 patients with an RPS treated between 1994 and 2015, 60 (20%) were aged 70 years and older (median age 74 years; range 70–85). The median tumor size was 24 cm (range 6–46). Forty-six patients (77%) had mass-related symptoms at the time of diagnosis. The most frequent histological subtypes were de-differentiated liposarcoma (53%, n = 32) and well-differentiated liposarcoma (35%, n = 21). Twenty-two patients (37%) had perioperative radiotherapy and/or chemotherapy. Fifty-eight patients (97%) had macroscopically complete resection. The postoperative mortality was 8% and severe morbidity (Dindo/Clavien ≥ 3) was 32%. A reoperation was required for ten patients (17%). After a median follow-up of 20 months (range 1–121), the 5-year overall survival (OS) rate was 90% (95% confidence interval [CI] 79–100%), and median OS was not reached. The cancer-specific death rate was 88%. No prognostic factor for disease-specific survival was detected. The 5-year disease-free survival (DFS) rate was 52% (95% CI 33–84%) and 5-year locoregional recurrence-free survival rate was 52% (95% CI 33–84%). Median DFS was 94 months (95% CI 35–NA). Reoperation after inappropriate surgery and postoperative morbidity were independent predictive factors of locoregional relapse. No predictive factors of distant metastasis were found.

Conclusions

Curative surgery is feasible in selected elderly patients but with higher mortality and morbidity rates than in younger patients. It enables a prolonged survival. Future studies should focus on selection process to minimize postoperative mortality and morbidity.

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Authors and Affiliations

  1. Department of Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif Cedex, France

    I. Sourrouille MD, R. Macovei MD, M. Faron MD & C. Honoré MD, PhD

  2. Department of Radiotherapy, Gustave Roussy Cancer Campus, Villejuif, France

    C. Le Péchoux MD & A. Le Cesne MD

  3. Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France

    O. Mir MD, PhD & S. Dumont MD, PhD

  4. Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France

    J. Adam MD, PhD & P. Terrier MD

Authors
  1. I. Sourrouille MD
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  2. R. Macovei MD
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  3. M. Faron MD
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  4. C. Le Péchoux MD
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  10. C. Honoré MD, PhD
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Correspondence to C. Honoré MD, PhD.

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Sourrouille, I., Macovei, R., Faron, M. et al. Long-Term Outcome After Surgery for a Localized Retroperitoneal Soft Tissue Sarcoma in Elderly Patients: Results from a Retrospective, Single-Center Study. Ann Surg Oncol 25, 2201–2208 (2018). https://doi.org/10.1245/s10434-018-6529-z

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  • DOI: https://doi.org/10.1245/s10434-018-6529-z

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