Retroperitoneal sarcomas: our experience

Retroperitoneal soft tissues sarcomas (STS) are relatively uncommon and constitute a difficult management problem. Although surgical resection is often difficult or impossible, current chemotherapy is not effective and radiation is limited by toxicity to adjacent structures. Thus, complete surgical resection remains the most effective modality for selected primary and recurrent disease. Fifteen patients with retroperitoneal STS were admitted and treated between January 1990 and January 2003, and prospectively followed. Nine patients underwent complete surgical resection of 8 malignant and 1 benign tumor. Two patients underwent incomplete surgical resection of 1 malignant and 1 benign tumor. Patient, tumor, and treatment variables were analyzed for disease-specific and disease-free survival. The patients with unresectable disease, incomplete resection, and high-grade tumors presented significantly reduced survival time. In this study, stage at presentation, high histologic grade, unresectable primary tumor, and positive gross margin are strongly associated with the tumor mortality rate. Patients approached with curative intent should undergo aggressive attempts at complete surgical resection. Incomplete resection should be undertaken only for symptoms relief. Because death often occurs as a result of local progression in retroperitoneal liposarcomas, it is possible that incomplete resection may be beneficial in this histologic type. Complete surgical resection is the most effective modality for the treatment of retroperitoneal sarcomas.