Analysis of prognostic factors associated with primary retroperitoneal sarcoma

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

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.

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.

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.