Retroperitoneal soft tissue sarcomas: prognosis and treatment of primary and recurrent disease in 117 patients.

Background: The objective of this study was to define prognostic factors for patients with primary soft tissue sarcomas (STS) arising from the retroperitoneum. Patients and Methods: One hundred and seventeen consecutive patients, resected in our institutions between July 1972 and November 2002, were reviewed. Results: The prognostic factors predicting survival were incomplete resection, a tumor of high grade (G3), metastases to lymph nodes and distant metastasis. Patients with a malignant fibrous histiocytoma (MFH) or a malignant peripheral nerve sheath tumor (MPNST) had a worse prognosis than those patients with other tumors. The prognostic factors predicting local recurrence were incomplete resection and high grade (G3). The prognostic factors predicting metastasis were incomplete resection, lymph node metastasis at the time of the resection of the primary tumor and tumor histology. Conclusion: Since only complete tumor resection offers a chance for cure, it is mandatory, and local control remains the most significant challenge in the management of retroperitoneal sarcomas. Other therapies can support surgical treatment, depending on the tumor localization and histological entity. The management of patients with a STS should be provided by a specialized team of surgeons, oncologists and radiotherapists, and patients should be enrolled in a treatment study whenever possible. Soft tissue sarcomas (STS) constitute a heterogeneous entity of neoplasms of different histological subtypes. Ten - 15% of all STS arise from the retroperitoneum (1, 2). Other than radical surgery, no other effective treatment is known to achieve local control and improved survival. Even if radiation is often applied after complete or incomplete resection, its role remains controversial. Patients (n=117) with primary retroperitoneal soft tissue sarcomas (RSTS), resected in the Hamburg and Dresden University Hospitals, Germany, were reviewed. Patients and Methods