Risk factors for recurrence and survival in patients with primary retroperitoneal tumors

Postoperative recurrence remains the major cause of death in patients with primary retroperitoneal tumors (PRT). This study aimed at investigating the potential biological and surgical factors associated with postoperative recurrence and survival in PRT patients.

Retrospective data were collected from 231 PRT patients from January 1980 and December 2005 from the General Hospital of PLA and Beijing Shijitan Hospital. Recurrence-free survival (RFS) was determined with the Kaplan-Meier method and Cox model. Clinicopathologocal and surgical variables were analyzed to determine their impact on the outcome of PRT.

The median follow-up period was 35 months (range 1-221). The most common histological subtype was liposarcoma (N=93, 40.3%), followed by malignant fibrous histiocytoma (MFH; N=46, 19.9%). Eighty-eight patients had local recurrence (71%) and 36 (29%) developed distant metastasis. On multivariate analysis, the surgical margin status and histological type were associated with postoperative recurrence. Patients with liposarcoma and MFH had significantly increased postoperative recurrence rate (p=0.008 and p=0.002, respectively). The overall survival in PRT patients was comparable between the incomplete resection group and the complete resection group (p=0.060), but significantly associated with the surgical resection (p=0.045).

Our results demonstrate that high tumor grade, histological subtype, incomplete resection and positive residual margins are strongly associated with PRT recurrence. Resection should be considered in patients with PRT for improving overall survival while prolonging RFS after resection.