Skip to main content

Advertisement

Log in

Surgical Approach and Oncologic Outcomes Following Multidisciplinary Management of Retrorectal Sarcomas

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Retrorectal sarcomas are rare, and limited data are available on oncologic outcomes following surgery. Our aim was to evaluate outcomes in this patient population at our institution.

Materials and Methods

All patients who underwent surgical resection of a malignant retrorectal/presacral sarcoma between 1985 and 2005 were identified. Data analyzed included demographics, histopathologic diagnosis, surgical morbidity and mortality, use of adjuvant therapy, local and distant recurrence, and survival.

Results

A total of 37 patients were identified (20 males) with a median age of 49 years (range, 22–81 years). The most common histopathologic diagnosis was malignant peripheral nerve sheath tumor (n = 8). Also, 22 tumors were high grade and 15 were low grade. Surgical margin status was R0 in 31 patients and R1 in 6. Adjuvant therapy was given to 26 patients. Postoperative morbidity and mortality was 57% and 3%, respectively. Median length of follow-up in 16 patients alive at last contact was 4.7 years. The 5-year survival free of local (LDFS), distant (DDFS), and local or distant recurrence (DFS) was 51, 58, and 39%, respectively. Patient survival at 2, 5, and 10 years was 75, 55, and 47%, respectively. Disease-free survival was not significantly associated with gender (P = .16), primary vs secondary (P = .94), R0 vs R1 resection (P = .26), low vs high tumor grade (P = .17), or the use of surgery with or without adjuvant therapy (P = .33).

Conclusions

Retrorectal sarcomas are often high grade and locally advanced. Most tumors are resectable with free margins, and long-term survival may be possible in up to one-half of patients following an aggressive surgical approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Cody HS 3rd, Marcove RC, Quan SH. Malignant retrorectal tumors: 28 years’ experience at Memorial Sloan-Kettering Cancer Center. Dis Colon Rectum. 1981;24:501–6.

    Article  PubMed  Google Scholar 

  2. Gray SW, Singhabhandhu B, Smith RA, Skandalakis JE. Sacrococcygeal chordoma: report of a case and review of the literature. Surgery. 1975;78:573–82.

    PubMed  CAS  Google Scholar 

  3. Jao SW, Beart RW Jr, Spencer RJ, Reiman HM, Ilstrup DM. Retrorectal tumors: Mayo Clinic experience, 1960–1979. Dis Colon Rectum. 1985;28:644–52.

    Article  PubMed  CAS  Google Scholar 

  4. Fuchs B, Dickey ID, Yaszemski MJ, Inwards CY, Sim FH. Operative management of sacral chordoma. J Bone Joint Surg. 2005;87:2211–6.

    Article  PubMed  Google Scholar 

  5. Jackman RJ, Clark PL III, Smith ND. Retrorectal tumors. JAMA. 1951;145:956–62.

    CAS  Google Scholar 

  6. Whittaker LD, Pemberton JD. Tumors ventral to the sacrum. Ann Surg. 1938;107:96–106.

    Article  PubMed  CAS  Google Scholar 

  7. Wang JY, Hsu CH, Changchien CR, Chen JS, Hsu KC, You YT, et al. Presacral tumor: a review of forty-five cases. Am Surg. 1995;61:310–5.

    PubMed  CAS  Google Scholar 

  8. Herr HW. Sarcomas of the urinary tract. In: de Kernion JB, Paulson DF, editors. Genitourinary Cancer Management. Philadelphia, PA: Lea & Febiger; 1987. p. 259–70.

  9. Russo P, Brady MS, Conlon K, Hajdu SI, Fair WR, Herr HW, et al. Adult urological sarcoma. J Urol. 1992;47:1032–7.

    Google Scholar 

  10. Mackenzie S, Reid R, Barrett A, O’Dwyer PJ. Management of soft tissue sarcomas of the abdomen and pelvis. Colorectal Dis. 2003;5:129–32.

    Article  PubMed  CAS  Google Scholar 

  11. Keyzer-Dekker CM, Houtkamp RG, Peterse JL, van Coevorden F. Adult pelvic sarcomas: a heterogeneous collection of sarcomas. Sarcoma. 2004;8:19–24.

    Article  PubMed  Google Scholar 

  12. Lewis JJ, Leung D, Woodruff JM, Brennan MF. Retroperitoneal soft-tissue sarcoma. Analysis of 500 patients treated and followed at a singe institution. Ann Surg. 1998;228:355–65.

    Article  PubMed  CAS  Google Scholar 

  13. Karakousis CP, Kontzoglou K, Driscoll DL. Resectability of retroperitoneal sarcomas; a matter of surgical technique? Eur J Surg Oncol. 1995;21:617–22.

    Article  PubMed  CAS  Google Scholar 

  14. Zhang G, Chen KK, Manivel C, Fraley EE. Sarcomas of the retroperitoneum and genitourinary tract. J Urol. 1989;141:1107–10.

    PubMed  CAS  Google Scholar 

  15. Raut CP, Pisters PW. Retroperitoneal sarcomas: combined-modality treatment approaches. J Surg Oncol. 2006;94:81–7.

    Article  PubMed  Google Scholar 

  16. Yang J, Chang A, Baker A, Sindelar WF, Danforth DN, Topalian SL, et al. Randomized prospective study of benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol. 1998;16:197–203.

    PubMed  CAS  Google Scholar 

  17. Feng M, Murphy J, Griffith KA. Long-term outcomes after radiotherapy for retroperitoneal and deep truncal sarcoma. Int J Radiat Oncol Biol Phys. 2007;69:103–10.

    Article  PubMed  Google Scholar 

  18. Rosenberg S, Tepper J, Glatstein E, Costa J, Baker A, Brennan M, et al. The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluation of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant therapy. Ann Surg. 1982;196:305–15.

    Article  PubMed  CAS  Google Scholar 

  19. Tierney J, Stewart L, Parmar M, et al. Adjuvant chemotherapy for localized resectable soft-tissue sarcoma of adult: meta-analysis of individual data. Lancet. 1997;350:1647–54.

    Article  Google Scholar 

  20. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, editors. AJCC Cancer Staging Manual. 7th ed. New York: Springer; 2010. p. 291.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eric J. Dozois MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dozois, E.J., Jacofsky, D.J., Billings, B.J. et al. Surgical Approach and Oncologic Outcomes Following Multidisciplinary Management of Retrorectal Sarcomas. Ann Surg Oncol 18, 983–988 (2011). https://doi.org/10.1245/s10434-010-1445-x

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-010-1445-x

Keywords

Navigation