Skip to main content

Advertisement

SpringerLink
Log in

Aggressive and frequent resection of recurrences in retroperitoneal sarcoma contributes to long-term survival

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

Retroperitoneal sarcoma (RPS) is a rare tumor with a poor prognosis and is often undetected until it is significantly enlarged. While surgical resection remains the primary treatment, there is little research on its benefits, especially that concerning the reoperation of recurrent disease. This study investigated the impact of surgical procedures, especially reoperation of recurrent RPS, on prognosis.

Methods

This retrospective study included 51 patients who underwent radical resection surgery (R0 status) for primary or recurrent RPS without distant metastasis. Patient outcomes and prognosis were defined in terms of the clinicopathologic factors and surgical techniques performed.

Results

In all cases, the 5-year disease-free survival (DFS) rate was 28.2%, 5-year overall survival rate was 89.9%, and 5-year no residual liposarcoma rate was 54.3% after operation and re-reoperation. There was a statistically significant difference between the 5-year DFS rate and 5-year no residual liposarcoma rate due to frequent re-reoperation (p = 0.011). On univariate analysis of primary and recurrent lesions, the histological type and the number of organs involved were identified as statistically significant prognostic factors. Patients with well-differentiated liposarcomas had a statistically better prognosis than those with other cancer types (primary RPS, p = 0.028; recurrence, p = 0.024).

Conclusions

Aggressive and frequent resection of recurrent RPS with combined resection of adjacent organs contributes to long-term survival. The establishment of a surgical strategy for RPS will require a prospective study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Yuri T, Miyaso T, Kitade H, Takasu K, Shikata N, Takada H, Tsubura A (2011) Well-differentiated liposarcoma, an atypical lipomatous tumor, of the mesentery: a case report and review of the literature. Case Rep Oncol 4:178–185

    Article  Google Scholar 

  2. Moyon FX, Moyon MA, Tufino JF, Yu A, Mafla OL, Molina GA. Massive retroperitoneal dedifferentiated liposarcoma in a young patient. J Surg Case Rep 2018;2018:rjy272

  3. Matthyssens LE, Creytens D, Ceelen WP (2015) Retroperitoneal liposarcoma: current insights in diagnosis and treatment. Front Surg 2:4

    Article  Google Scholar 

  4. Kotilingam D, Lev DC, Lazar AJ, Pollock RE (2006) Staging soft tissue sarcoma: evolution and change. CA Cancer J Clin 56:282–291 quiz 314-5

    Article  Google Scholar 

  5. Nathenson MJ, Barysauskas CM, Nathenson RA, Regine WF, Hanna N, Sausville E (2018) Surgical resection for recurrent retroperitoneal leiomyosarcoma and liposarcoma. World J Surg Oncol 16:203

    Article  Google Scholar 

  6. Dalal KM, Kattan MW, Antonescu CR, Brennan MF, Singer S (2006) Subtype specific prognostic nomogram for patients with primary liposarcoma of the retroperitoneum, extremity, or trunk. Ann Surg 244:381–391

    Article  Google Scholar 

  7. Peterson MA (2003) Introduction: who shall lead? J Health Polit Policy Law 28:181–194

    Article  Google Scholar 

  8. Trans-Atlantic RPSWG (2015) Management of primary retroperitoneal sarcoma (RPS) in the adult: a consensus approach from the Trans-Atlantic RPS Working Group. Ann Surg Oncol 22:256–263

    Article  Google Scholar 

  9. Agrusa A, Di Buono G, Buscemi S et al (2019) Dedifferentiated retroperitoneal large liposarcoma and laparoscopic treatment: is it possible and safe? The first literature case report. Int J Surg Case Rep 57:113–117

    Article  Google Scholar 

  10. Fletcher CDM, Hogendoorn P, Mertens F (2013) WHO classification of tumors of soft tissue and bone. Lyon: IARC Press:321–324

  11. Nishimura J, Morii E, Takahashi T, Souma Y, Nakajima K, Doki Y, Nishida T (2010) Abdominal soft tissue sarcoma: a multicenter retrospective study. Int J Clin Oncol 15:399–405

    Article  Google Scholar 

  12. Sassa N, Yokoyama Y, Nishida Y, Yamada S, Uchida H, Kajiyama H, Nagino M, Kodera Y, Gotoh M (2020) Clinical characteristics and surgical outcomes of retroperitoneal tumors: a comprehensive data collection from multiple departments. Int J Clin Oncol 25:929–936

    Article  Google Scholar 

  13. Sato H, Minei S, Sugimoto S, Kishimoto Y, Yoshida T, Takimoto Y (2004) Multicentric liposarcoma. Int J Urol 11:1133–1135

    Article  Google Scholar 

  14. Doyle LA (2014) Sarcoma classification: an update based on the 2013 World Health Organization classification of tumors of soft tissue and bone. Cancer 120:1763–1774

    Article  Google Scholar 

  15. Luo P, Cai W, Yang L, Wu Z, Chen Y, Zhang R, Yan W, Shi Y, Wang C (2018) Retroperitoneal dedifferentiated liposarcoma: analysis of 61 cases from a large institution. J Cancer 9:3831–3838

    Article  Google Scholar 

  16. Tanaka K, Ozaki T (2019) New TNM classification (AJCC eighth edition) of bone and soft tissue sarcomas: JCOG bone and soft tissue tumor study group. Jpn J Clin Oncol 49:103–107

    Article  Google Scholar 

  17. Singer S, Antonescu CR, Riedel E, Brennan MF (2003) Histologic subtype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma. Ann Surg 238:358–370 discussion 70-1

    Article  Google Scholar 

  18. Ikeguchi M, Urushibara S, Shimoda R, Saito H, Wakatsuki T (2014) Surgical treatment of retroperitoneal liposarcoma. Yonago Acta Med 57:129–132

    PubMed  PubMed Central  Google Scholar 

  19. Gronchi A, Lo Vullo S, Fiore M, Mussi C, Stacchiotti S, Collini P, Lozza L, Pennacchioli E, Mariani L, Casali PG (2009) Aggressive surgical policies in a retrospectively reviewed single-institution case series of retroperitoneal soft tissue sarcoma patients. J Clin Oncol 27:24–30

    Article  Google Scholar 

  20. Willis F, Schimmack S, Uhl M, Haefner MF, Mechtersheimer G, Hinz U, Schmidt T, Debus J, Fröhling S, Schneider M (2020) Significance of intraoperative radiation therapy and high cumulative radiation doses in retroperitoneal soft tissue sarcoma. Eur J Surg Oncol 46:905–913

    Article  Google Scholar 

  21. Bonvalot S, Rivoire M, Castaing M, Stoeckle E, le Cesne A, Blay JY, Laplanche A (2009) Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol 27:31–37

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan

    Koji Komori, Takashi Kinoshita, Taihei Oshiro, Akira Ouch, Seiji Ito, Tetsuya Abe, Kazunari Misawa, Yuichi Ito, Seiji Natsume, Eiji Higaki, Masataka Okuno, Takahiro Hosoi, Kawakatsu Shoji, Aina Kunitomo, Satoshi Oki, Yasuhito Suenaga, Shingo Maeda, Takuya Nagao, Hideyuki Dei, Yoshihisa Numata, Tsukasa Aritake, Kakeru Tawada & Yasuhiro Shimizu

  2. Department of Orthopedic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan

    Satoshi Tsukushi & Masahiro Yoshida

Authors
  1. Koji Komori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Satoshi Tsukushi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masahiro Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takashi Kinoshita
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Taihei Oshiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Akira Ouch
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Seiji Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tetsuya Abe
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kazunari Misawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yuichi Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Seiji Natsume
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Eiji Higaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Masataka Okuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Takahiro Hosoi
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Kawakatsu Shoji
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Aina Kunitomo
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Satoshi Oki
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Yasuhito Suenaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Shingo Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Takuya Nagao
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Hideyuki Dei
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Yoshihisa Numata
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Tsukasa Aritake
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Kakeru Tawada
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. Yasuhiro Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Koji Komori.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Ethical approval

This study was approved by the Ethics Committee of Aichi Cancer Center, Chikusa-ku Nagoya, Japan (2020-1-095).

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Supplementary Material 1

A midline cutaneous incision is performed along with a transverse incision (PDF 916 kb)

Supplementary Material 2

The mechanism of unexpected massive bleeding during RPS resection (PDF 18 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Komori, K., Tsukushi, S., Yoshida, M. et al. Aggressive and frequent resection of recurrences in retroperitoneal sarcoma contributes to long-term survival. Langenbecks Arch Surg 406, 1635–1642 (2021). https://doi.org/10.1007/s00423-020-02062-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-020-02062-z

Keywords

Search

Navigation