Locoregional recurrence of retroperitoneal soft tissue sarcoma: second chance of cure for selected patients

• Published in: European journal of surgical oncology Vol. 27; no. 6; pp. 564 - 568
• Main Authors: van Dalen, Th, Hoekstra, H.J., van Geel, A.N., van Coevorden, F., Albus-Lutter, Ch, Slootweg, P.J., Hennipman, A.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01-09-2001; Elsevier
• Subjects: Abdomen; Adult; Aged; Analysis of Variance; Biological and medical sciences; Biopsy, Needle; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Neoplasm Staging; Predictive Value of Tests; Probability; Prognosis; recurrence; Reoperation; Retroperitoneal Neoplasms - mortality; Retroperitoneal Neoplasms - pathology; Retroperitoneal Neoplasms - surgery; retroperitoneum; Retrospective Studies; Risk Factors; Sarcoma - mortality; Sarcoma - pathology; Sarcoma - surgery; soft tissue sarcoma; Statistics, Nonparametric; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Analysis; Treatment Outcome; Tumors; recurrence; soft tissue sarcoma; retroperitoneum; prognosis; Human; Recurrence; Prognosis; Retroperitoneal; Sarcoma; Selection; Patient; Malignant tumor; Regional; Premises; Long term; Survival; Retrospective; Retreatment; Treatment; Exeresis; Abdominal disease; Surgery; Soft tissue; Predictive factor
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1053/ejso.2001.1166

Background: Locoregional recurrence of a retroperitoneal soft tissue sarcoma (RSTS) may offer a second chance of curative surgical treatment. In a population-based study the proportion of patients developing isolated locoregional recurrences (LR) was determined and the outcome of these patients was analysed. Method: In a retrospective nationwide study, data were collected on 142 patients treated between 1 January 1989 and 1 January 1994 for primary RSTS. In patients who had been treated radically for their primary sarcoma (77/142, 54%), the pattern of recurrence was evaluated. Factors predictive of survival for patients with LR were studied. Results: After a median follow-up of 86 (range 60–101) months, 32 patients (42%) had developed LR, and distant metastasis (DM) had been diagnosed in 17 patients (22%). Median disease-free interval between the initial operation and the establishment of LR or DM was 22 and 19 months, respectively. Five-year cumulative survival of patients with established LR was 37% in comparison with 11% for patients with DM (P=0.062). Factors predictive of favourable outcome in patients with LR were the absence of multifocal recurrence (n=13 P=0.01), lipomatous histomorphology (n=20 P=0.02), and a complete resection of recurrent sarcoma (n=17 P=0.04). Conclusion: After a median follow-up of 7 years following radical treatment of a primary RSTS, 42% of the patients had developed isolated locoregional recurrences. A complete resection of recurrent disease, lipomatous histomorphology and the absence of multifocal growth influenced prognosis favourably.