Mid-term outcomes in the treatment of retroperitoneal sarcomas: a 12-year single-institution experience

Abstract

<p><strong>Aim</strong> <br />To present the experience from collective data regarding patients with retroperitoneal sarcomas that have been operated in and followed up by the University General Hospital of Patras in Rion, Greece, between 2009 and 2020.<br />Methods A retrospective analysis of adult patients treated at our hospital with a diagnosis of primary retroperitoneal sarcoma who underwent tumour resection.<br /><strong>Results</strong> <br />Data from 29 patients were analysed. The mean age at diagnosis was 56.1 years; 55.2% of patients were male (n=16). Liposarcomas (on histology) were identified in 19 (65.5%) patients, leiomyosarcoma six (20.7%), and other histologic subtypes in four (13.8%) patients. Tumours >5cm were presented in 27 (93.1%) patients. Negative margins were attained in 13 (44.8%) of all patients who underwent surgical resection. Five (17.2%) patients received neoadjuvant radiation, four (13.8%) postoperative radiation, and three (10.3%) patients received both chemotherapy and radiation<br />prior to surgery with the rest of the patients being treated with surgical excision alone. A 3-year follow-up was successful in 21 (72.4%) patients; five (23.8%) patients died. In total, 16 (55.2%) patients were found to have a local recurrence, with no significant difference in patients' age, gender, tumour size, histology, negative surgical margin (Ro) resection, neoadjuvant chemotherapy, or radiation therapy. There was a significant difference in the 3-year survival rate between patients having positive or negative surgical margins (p=0.027).<br /><strong>Conclusion</strong> <br />The higher 3-year survival rate in patients with retroperitoneal sarcomas when achieving Ro resection warrant further<br />investigation with a larger sample size across different institutions. </p>

Inguinoscrotal Hernia: An Unusual Presentation of Retroperitoneal Liposarcoma

“…Although chemotherapy protocols and radiation therapy are still considered effective supplementary treatments, surgical intervention involving complete tumor removal, indicated by negative surgical margins, continues to be the preferred method. Research suggests a notable disparity in mid-term survival rates between patients who undergo adequate tumor excision and those with positive surgical margins, thereby reinforcing the superiority of surgical treatment as the optimal approach [13].…”

CT and MR Imaging of Retroperitoneal Sarcomas: A Practical Guide for the Radiologist

“…This is achieved by en bloc resection of the tumor and all surrounding structures, even if not overtly infiltrated on imaging or surgical exploration [2,7,11,17,18,51], with the aim of obtaining R0 margins; however, this goal is difficult, especially in nonspecialized centers. Since patients with R1 margins tend to have significantly lower mid-term survival rates and higher recurrence rates [52][53][54][55], but at the same time a far too demolitive surgery can have a certain impact on a patient's life, the optimal extent of resection is still debated and considers several factors, such as histological subtype, preoperative therapies, or anatomical barriers. Novel surgical techniques are being adopted to improve radical excision [52,53].…”

Case Report: Successful R0 resection in locally advanced retroperitoneal sarcomas

“…This is especially true in the case of retroperitoneal liposarcoma, which calls for specialist management in centers with experience in management, and a multi-disciplinary team integrating surgery, radiology, and oncology, along with case-specific involvement from other fields. Diagnostic imaging is complex requiring multiple modalities, and post-operative follow-up is exhausting necessitating consistent imaging to detect recurrence ( 4 ).…”

“…Recent studies have challenged this concept and suggested compartmentalization as a method to decrease tumor recurrence, which, in the case of retroperitoneal sarcomas, is the leading cause of death ( 2 ). R0 excision has now become the gold standard of management of retroperitoneal sarcomas, with consistent improvement in survival rates ( 3 , 4 ).…”