Prognostic factors for first recurrence in patients with retroperitoneal sarcoma

Prognostic factors for first recurrence in patients with retroperitoneal sarcoma

Retroperitoneal sarcomas are characterized by a high local recurrence rate despite optimal surgical treatment. The definition of prognostic factors for recurrence could help offer high-risk patients a closer follow-up and a multidisciplinary therapeutic approach. A cohort of 40 patients treated for...

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Bibliographic Details
Published in:Urologic oncology Vol. 24; no. 2; pp. 94 - 96
Main Authors: Avancès, Christophe, Mottet, Nicolas, Mahatmat, Aba, Chapuis, Eliette, Serre, Isabelle, Culine, Stéphane
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01-03-2006
Elsevier Science
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Complete excision
Female
Follow-Up Studies
Humans
Male
Medical sciences
Middle Aged
Multivariate analysis
Neoplasm Recurrence, Local - epidemiology
Nephrology. Urinary tract diseases
Prognosis
Prognostic factors
Retroperitoneal Neoplasms - epidemiology
Retroperitoneal sarcoma
Sarcoma - epidemiology
Surgery
Tumor grade
Tumors
Retroperitoneal sarcoma
Complete excision
Multivariate analysis
Tumor grade
Surgery
Prognostic factors
Histological grading
Human
Relapse
Nephrology
Prognosis
Excision
Complete
Soft tissue sarcoma
Retroperitoneal disease
Malignant tumor
Urology
Cancerology
Treatment
Abdominal disease
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Summary:Retroperitoneal sarcomas are characterized by a high local recurrence rate despite optimal surgical treatment. The definition of prognostic factors for recurrence could help offer high-risk patients a closer follow-up and a multidisciplinary therapeutic approach. A cohort of 40 patients treated for a primary retroperitoneal sarcoma was retrospectively analyzed. Median follow-up was 24 months. Patient (sex and age), tumor (maximal size, histologic type, tumor localization, and histologic grade), and treatment (complete vs. incomplete surgery) characteristics were included in univariate and multivariate prognostic factor analyses. After a median follow-up of 24 months (range 3−121), the overall recurrence rate was 65%. Median time between initial surgery and recurrence was 15 months (range 11.5−29.5). In univariate analysis, surgical positive margins ( P = 0.011), bilateral tumors ( P = 0.0034), nonliposarcoma histologic subtypes ( P = 0.043), and a high histologic grade ( P = 0.0072) were associated with an increased recurrence rate. All these factors except the histologic subtypes retained an independent prognostic value in the multivariate analysis. Death was strongly related to recurrence ( P = 0.0033). The optimal treatment of patients with primary retroperitoneal sarcoma should be based on radical surgery, with en bloc organ resection if necessary, to minimize the risk of positive margins. In high-risk patients, close follow-up is mandatory to offer optimal subsequent surgical procedures. The impact of a multidisciplinary therapeutic approach remains to be proved.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2005.09.004