Resectability and survival in retroperitoneal sarcomas

Background: Retroperitoneal sarcomas historically have presented difficulties in their management due to a high rate of unresectability, which affects the survival of these patients. Methods: We retrospectively reviewed the charts of 87 consecutive patients with retroperitoneal sarcomas treated in the period 1977-1994. Results: The resectability rate was 100% for the primary tumors (n = 55) and 87% for the locally recurrent tumors (n = 32). The 5-year survival rate was 63% (66% for the primary tumors and 57% for those with local recurrence). The 10-year survival rate was 46% (57% for primary tumors and 26% for those referred with locally recurrent tumor). The overall local recurrence rate was 31% (25% for the primary tumors and 41% for those referred with local recurrence); it was 56% after local excision and 15% after wide resection (p = 0.0003). The 10-year disease-free survival of patients with local excision (n = 25) was 7%, and that of patients with wide resection (n = 54) 59% (p = 0.0001). Conclusions: The overall resectability rate of retroperitoneal sarcomas was 95%. Wide resection produced a significantly higher survival rate compared with that of local excision. The survival rate for the primary tumors, varying significantly with the histologic grade, approached the rate reported for primary soft-tissue sarcomas of the extremity.