• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of annsurgLink to Publisher's site
Ann Surg. Sep 1998; 228(3): 355–365.
PMCID: PMC1191491

Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution.

Abstract

OBJECTIVE: To analyze treatment and survival of a large cohort of patients with retroperitoneal soft-tissue sarcomas (STS) treated and prospectively followed at a single institution. SUMMARY BACKGROUND DATA: Retroperitoneal STS are relatively uncommon and constitute a difficult management problem. Although surgical resection is often difficult or impossible, current chemotherapy is not effective and radiation is limited by toxicity to adjacent structures. Thus, complete surgical resection remains the most effective modality for selected primary and recurrent disease. METHODS: Five hundred patients with retroperitoneal STS were admitted and treated between July 1, 1982, and September 30, 1997, and prospectively followed. Patient, tumor, and treatment variables were analyzed for disease-specific and disease-free survival. Survival was determined with the Kaplan-Meier method. Statistical significance was evaluated using the logrank test for univariate influence and Cox model stepwise regression for multivariate influence. RESULTS: Two hundred seventy-eight patients (56%) had primary disease and 222 (44%) recurrent disease. Median follow-up was 28 months (range 1 to 172 months), 40 months for survivors. Median survival was 72 months for patients with primary disease, 28 months for those with local recurrence, and 10 months for those with metastasis. For patients with primary or locally recurrent tumors, unresectable disease, incomplete resection, and high-grade tumors significantly reduced survival time. CONCLUSIONS: In this study of patients with retroperitoneal STS, stage at presentation, high histologic grade, unresectable primary tumor, and positive gross margin are strongly associated with the tumor mortality rate. Patients approached with curative intent should undergo aggressive attempts at complete surgical resection. Incomplete resection should be undertaken only for symptom relief.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.5M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Lewis JJ, Brennan MF. Soft tissue sarcomas. Curr Probl Surg. 1996 Oct;33(10):817–872. [PubMed]
  • Jaques DP, Coit DG, Hajdu SI, Brennan MF. Management of primary and recurrent soft-tissue sarcoma of the retroperitoneum. Ann Surg. 1990 Jul;212(1):51–59. [PMC free article] [PubMed]
  • Karakousis CP, Gerstenbluth R, Kontzoglou K, Driscoll DL. Retroperitoneal sarcomas and their management. Arch Surg. 1995 Oct;130(10):1104–1109. [PubMed]
  • Lewis JJ, Benedetti F. Adjuvant therapy for soft tissue sarcomas. Surg Oncol Clin N Am. 1997 Oct;6(4):847–862. [PubMed]
  • Hajdu SI, Shiu MH, Brennan MF. The role of the pathologist in the management of soft tissue sarcomas. World J Surg. 1988 Jun;12(3):326–331. [PubMed]
  • Gaynor JJ, Tan CC, Casper ES, Collin CF, Friedrich C, Shiu M, Hajdu SI, Brennan MF. Refinement of clinicopathologic staging for localized soft tissue sarcoma of the extremity: a study of 423 adults. J Clin Oncol. 1992 Aug;10(8):1317–1329. [PubMed]
  • PACK GT, TABAH EJ. Primary retroperitoneal tumors: a study of 120 cases. Int Abstr Surg. 1954 Sep;99(3):209–contd. [PubMed]
  • Karakousis CP, Kontzoglou K, Driscoll DL. Resectability of retroperitoneal sarcomas: a matter of surgical technique? Eur J Surg Oncol. 1995 Dec;21(6):617–622. [PubMed]
  • Singer S, Corson JM, Demetri GD, Healey EA, Marcus K, Eberlein TJ. Prognostic factors predictive of survival for truncal and retroperitoneal soft-tissue sarcoma. Ann Surg. 1995 Feb;221(2):185–195. [PMC free article] [PubMed]
  • Storm FK, Eilber FR, Mirra J, Morton DL. Retroperitoneal sarcomas: a reappraisal of treatment. J Surg Oncol. 1981;17(1):1–7. [PubMed]
  • Storm FK, Mahvi DM. Diagnosis and management of retroperitoneal soft-tissue sarcoma. Ann Surg. 1991 Jul;214(1):2–10. [PMC free article] [PubMed]
  • Kinsella TJ, Sindelar WF, Lack E, Glatstein E, Rosenberg SA. Preliminary results of a randomized study of adjuvant radiation therapy in resectable adult retroperitoneal soft tissue sarcomas. J Clin Oncol. 1988 Jan;6(1):18–25. [PubMed]
  • Russo P, Kim Y, Ravindran S, Huang W, Brennan MF. Nephrectomy during operative management of retroperitoneal sarcoma. Ann Surg Oncol. 1997 Jul-Aug;4(5):421–424. [PubMed]
  • Lindberg RD, Martin RG, Romsdahl MM, Barkley HT., Jr Conservative surgery and postoperative radiotherapy in 300 adults with soft-tissue sarcomas. Cancer. 1981 May 15;47(10):2391–2397. [PubMed]
  • Potter DA, Glenn J, Kinsella T, Glatstein E, Lack EE, Restrepo C, White DE, Seipp CA, Wesley R, Rosenberg SA. Patterns of recurrence in patients with high-grade soft-tissue sarcomas. J Clin Oncol. 1985 Mar;3(3):353–366. [PubMed]
  • Leibel SA, Tranbaugh RF, Wara WM, Beckstead JH, Bovill EG, Phillips TL. Soft tissue sarcomas of the extremities: survival and patterns of failure with conservative surgery and postoperative irradiation compared to surgery alone. Cancer. 1982 Sep 15;50(6):1076–1083. [PubMed]
  • Suit HD, Mankin HJ, Wood WC, Proppe KH. Preoperative, intraoperative, and postoperative radiation in the treatment of primary soft tissue sarcoma. Cancer. 1985 Jun 1;55(11):2659–2667. [PubMed]
  • Brennan MF, Hilaris B, Shiu MH, Lane J, Magill G, Friedrich C, Hajdu SI. Local recurrence in adult soft-tissue sarcoma. A randomized trial of brachytherapy. Arch Surg. 1987 Nov;122(11):1289–1293. [PubMed]
  • Harrison LB, Franzese F, Gaynor JJ, Brennan MF. Long-term results of a prospective randomized trial of adjuvant brachytherapy in the management of completely resected soft tissue sarcomas of the extremity and superficial trunk. Int J Radiat Oncol Biol Phys. 1993 Sep 30;27(2):259–265. [PubMed]
  • Rosenberg SA, Kent H, Costa J, Webber BL, Young R, Chabner B, Baker AR, Brennan MF, Chretien PB, Cohen MH, et al. Prospective randomized evaluation of the role of limb-sparing surgery, radiation therapy, and adjuvant chemoimmunotherapy in the treatment of adult soft-tissue sarcomas. Surgery. 1978 Jul;84(1):62–69. [PubMed]
  • Clark JA, Tepper JE. Role of radiation therapy in retroperitoneal sarcomas. Oncology (Williston Park) 1996 Dec;10(12):1867–1874. [PubMed]
  • Ueda T, Aozasa K, Tsujimoto M, Hamada H, Hayashi H, Ono K, Matsumoto K. Multivariate analysis for clinical prognostic factors in 163 patients with soft tissue sarcoma. Cancer. 1988 Oct 1;62(7):1444–1450. [PubMed]
  • Tepper JE, Suit HD, Wood WC, Proppe KH, Harmon D, McNulty P. Radiation therapy of retroperitoneal soft tissue sarcomas. Int J Radiat Oncol Biol Phys. 1984 Jun;10(6):825–830. [PubMed]
  • Willett CG, Suit HD, Tepper JE, Mankin HJ, Convery K, Rosenberg AL, Wood WC. Intraoperative electron beam radiation therapy for retroperitoneal soft tissue sarcoma. Cancer. 1991 Jul 15;68(2):278–283. [PubMed]
  • Lewis JJ, Leung D, Heslin M, Woodruff JM, Brennan MF. Association of local recurrence with subsequent survival in extremity soft tissue sarcoma. J Clin Oncol. 1997 Feb;15(2):646–652. [PubMed]
  • Alvarenga JC, Ball AB, Fisher C, Fryatt I, Jones L, Thomas JM. Limitations of surgery in the treatment of retroperitoneal sarcoma. Br J Surg. 1991 Aug;78(8):912–916. [PubMed]
  • Cody HS, 3rd, Turnbull AD, Fortner JG, Hajdu SI. The continuing challenge of retroperitoneal sarcomas. Cancer. 1981 May 1;47(9):2147–2152. [PubMed]
  • Kilkenny JW, 3rd, Bland KI, Copeland EM., 3rd Retroperitoneal sarcoma: the University of Florida experience. J Am Coll Surg. 1996 Apr;182(4):329–339. [PubMed]
  • McGrath PC, Neifeld JP, Lawrence W, Jr, DeMay RM, Kay S, Horsley JS, 3rd, Parker GA. Improved survival following complete excision of retroperitoneal sarcomas. Ann Surg. 1984 Aug;200(2):200–204. [PMC free article] [PubMed]
  • Lewis JJ, Houghton AN. Definition of tumor antigens suitable for vaccine construction. Semin Cancer Biol. 1995 Dec;6(6):321–327. [PubMed]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...