Textbook Outcomes for Retroperitoneal Sarcoma Resection: A Multi-Centre Review.

Area of Science:

• Surgical Oncology
• Oncologic Outcomes Research
• Health Services Research

Background:

• Retroperitoneal sarcomas (RPSs) require en-bloc resection for potential cure.
• Textbook outcomes (TOs) are composite measures for evaluating ideal surgical results in complex cancer resections.

Purpose of the Study:

• Define TO for RPS resections.
• Investigate factors influencing TO achievement, including treatment service.
• Assess the impact of treatment service on achieving TO.

Main Methods:

• Retrospective review of 144 adult patients undergoing primary RPS resection in Queensland (2012-2022).
• Data sourced from the Queensland Oncology Repository (QOR).
• TO defined by specific criteria including en-bloc resection, negative margins, complication avoidance, and short hospital stay.

Main Results:

• 56.94% of patients achieved a TO.
• Negative predictors for TO included high-grade subtype, multi-organ resection, major vascular resection, and non-high-volume sarcoma center (HVSC) treatment.
• Treatment at an HVSC independently increased TO likelihood by 2.6-fold (p=0.02).

Conclusions:

• TOs measure RPS resection quality across health services.
• Patients treated at HVSCs have a higher probability of achieving TOs.
• Achieving TOs correlates with improved 5-year disease-free survival (DFS) and overall survival (OS).