Effect of resection and outcome in patients with retroperitoneal sarcoma.

Background:  A consecutive series of 47 patients with retroperitoneal sarcoma (RPS) were resected and prospectively followed. Method:  Between July 1994 and March 2005, 47 patients (24 men, 23 women; mean age, 56 years; range, 17–82 years) were evaluated. Results:  A total of 23 patients had primary RPS and 24 patients had recurrent RPS. A total of 30 out of 47 patients (64%) underwent removal of contiguous intra-abdominal organs. The peroperative mortality was nil and significant preoperative complications occurred in eight cases only (17%). High tumour grade and incomplete resection were significant variables for a worse survival in all 47 patients, both in the univariate and multivariate analyses (P = 0.008 and P = 0.016, respectively). Among 28 radically resected patients, only histological grade affected overall survival (90% 5-year survival for low-grade tumour vs 26% 5-year survival for high-grade tumour; P = 0.006) with a similar effect noted for disease-free survival. Conclusions:  Histological grade was the only factor that affected overall and disease-free survival for RPS tumours. An aggressive surgical approach in both primary and recurrent RPS is associated with long-term survival.