Analysis of prognostic factors associated with primary retroperitoneal sarcoma.

OBJECTIVE

To explore the prognostic factors associated with recurrence and survival in patients with retroperitoneal sarcoma.

METHODS

A retrospective analysis was performed in 77 patients who were affected by primary Retroperitoneal Sarcoma and treated with surgery between January 1980 and December 2005.

RESULTS

57 cases developed local recurrence and 3 had metastases after surgery. The overall recurrence rate was 74%. Median time between initial surgery and recurrence was 14.8 months (range 3.2-99.6). There were 27 patients who died of disease and 5 for other reasons. The median survival time was 42.5 months (range 3.6-180.4). The overall 5-year and 10-year survival rates were 61.7 and 43.9%,respectively. The 5-year and 10-year relapse-free survival rates were 22.7 and 16.8%, respectively. In univariate analysis, female sex (p = 0.047), tumor size < 15 cm (p = 0.045), complete tumor resection (p < 0.001), no adjacent visceral involvement (p = 0.012) and no local recurrence (p = 0.001) were found to have prognostic significance for a decreased risk of tumor-related mortality. When subjected to Cox multivariate analysis, the only factor found to decrease the risk of tumor-related mortality was complete tumor resection (p = 0.001). Incomplete tumor resection (p = 0.019) and high tumor grade (p = 0.042) were associated with an increased local recurrence rate.

CONCLUSIONS

Complete surgical resection at the time of primary tumor presentation affords the best chance for local control and long-term survival. Patients with high-grade tumor present a significant risk of local relapse after surgery.