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Inoperable Primary Retroperitoneal Sarcomas: Clinical Characteristics and Reasons Against Resection at a Single Referral Institution

  • Sarcoma
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The outcome of patients with retroperitoneal sarcomas (RPS) depends mainly on tumor biology and completeness of surgical resection. However, some patients are deemed not resectable for various reasons. This study analyzed a series of primary RPS patients to describe rate and reasons of primary inoperability at a large referral center.

Methods

All consecutive patients affected by primary localized RPS referred for surgical treatment at our institution between January 1, 2013 and December 31, 2017 were analyzed. Patients were split in two groups: those who underwent surgical resection with curative intent, and those who were not resected.

Results

A total of 322 patients were available for the current analysis: 285 (88.5%) underwent resection with curative intent, and 37 (11.5%) did not. Twenty of 322 (6.2%) patients who did not undergo resection had a technically unresectable tumor, whereas the remaining 18 of 322 (5.6%) were not amenable to a major surgical procedure due to comorbidities/poor performance status. The dominant technical reason was involvement of the celiaco-mesenteric vessels. At a median follow-up from the diagnosis of 34 months, 24 of 37 (64.9%) nonoperated and 48 of 285 (16.8%) operated patients died. The corresponding 4-year overall survival were 10.3% and 83.4%, respectively (p < 0.001).

Conclusions

Roughly, 10% of patients who presented with localized primary RPS at a large referral institution were not resected. An attempt to standardize the definition of resectability for primary localized RPS should be made considering anatomic, biologic, and patient-related factors.

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Authors and Affiliations

  1. Department of Surgery, Institute of Oncology Ljubljana, Ljubljana, Slovenia

    Andraz Perhavec MD

  2. European School of Soft Tissue Sarcoma Surgery, Milan, Italy

    Andraz Perhavec MD

  3. Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Salvatore Provenzano MD

  4. Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Marco Baia MD, Chiara Colombo MD, Stefano Radaelli MD, Sandro Pasquali MD, Dario Callegaro MD, Alessandro Gronchi MD & Marco Fiore MD

  5. Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Claudia Sangalli MD

  6. Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Carlo Morosi MD

  7. Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Marta Barisella MD

Authors
  1. Andraz Perhavec MD
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  2. Salvatore Provenzano MD
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  3. Marco Baia MD
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  4. Claudia Sangalli MD
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  5. Carlo Morosi MD
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  6. Marta Barisella MD
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  7. Chiara Colombo MD
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  8. Stefano Radaelli MD
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  9. Sandro Pasquali MD
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  10. Dario Callegaro MD
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  11. Alessandro Gronchi MD
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  12. Marco Fiore MD
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Correspondence to Marco Fiore MD.

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Perhavec, A., Provenzano, S., Baia, M. et al. Inoperable Primary Retroperitoneal Sarcomas: Clinical Characteristics and Reasons Against Resection at a Single Referral Institution. Ann Surg Oncol 28, 1151–1157 (2021). https://doi.org/10.1245/s10434-020-08789-9

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  • DOI: https://doi.org/10.1245/s10434-020-08789-9

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