Retroperitoneal sarcomas: the Yale experience and a review of the literature

Between 1964 and 1978, 23 patients were referred for radiation therapy for retroperitoneal sarcoma. Three patients had complete excision and negative resection margins and all survived for 5 years without recurrent disease. One patient had complete resection but positive margins, but had a local recurrence 3 1/2 years after radiation. One patient had partial excision with gross residual, and this patient survived only 17 months after an incomplete radiation treatment schedule. Ten cases had biopsy only and were then referred. We found that there were only four cases that survived longer than 1 year, and their average dose of radiation was 4,400 rads, as compared to only 2,691 rads for the remaining six. We conclude that for incompletely resected or only biopsied retroperitoneal sarcoma, doses of 4,000-5,000 rads should be given and then a reevaluation for complete resection should be done with CT scan and reexploration. For completely resected cases, we feel that postoperative radiation adds to the local control. We have reviewed the literature and presented the data in support of our conclusions.