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Results of Resection for Recurrent or Residual Retroperitoneal Sarcoma After Failed Primary Treatment

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

Abstract

Background

Local recurrence after resection of retroperitoneal sarcoma (RPS) is a common and difficult problem. Gross residual disease after incomplete resection is a particular challenge. The authors reviewed their experience with patients referred for management of recurrent or residual RPS.

Methods

Patients seen at the authors’ center from 1996 to 2013 who had undergone resection at an outside institution were identified from a prospective database. Kaplan–Meier survival curves were generated and compared by log-rank analysis.

Results

A total of 45 patients were referred with recurrent (n = 33) or residual (n = 12) disease. Before initial surgery elsewhere, cross-sectional imaging (computed tomograpy/magnetic resonance imaging) had been obtained for 30 patients (67 %) and percutaneous biopsy for 8 patients (18 %). At referral to the authors’ center, 15 patients were deemed inappropriate for resection, with a subsequent median overall survival (OS) period of 15 months. At the authors’ center, 30 patients (22 with recurrent and 8 with residual disease) were resected. The majority received preoperative radiation (77 %). The postoperative mortality rate was 0 % in the recurrent group and 25 % (2/8) in the residual group (p = 0.015). Among the 30 resected patients, the median and 5-year OS was 53 months (50 %), and the OS was better in the recurrent group (median, 77 months) than in the residual group (median, 41 months (p = 0.027). The median time to local re-recurrence was 49 months in the recurrent group and 35 months in the residual group (p = 0.730).

Conclusions

Durable disease control and prolonged survival may be achieved for selected patients with recurrent RPS. In this study, resection after previous grossly incomplete resection was associated with high postoperative mortality and inferior OS. The benefit of extensive surgery for these patients may be limited.

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Acknowledgement

The Jim Chamberlain Sarcoma Research Fund, at the Princess Margaret Cancer Centre, Toronto.

Conflict of Interest

There are no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Surgery, University of British Columbia, Vancouver, BC, Canada

    Trevor D. Hamilton MD

  2. Ontario Institute for Cancer Research, Toronto, ON, Canada

    Amanda J. Cannell BSc

  3. Division of General Surgery, McMaster University, Hamilton, ON, Canada

    Minji Kim BSc, MD

  4. Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Charles N. Catton MD

  5. Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Martin E. Blackstein MD, PhD

  6. Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada

    Brendan C. Dickson MD, MSc

  7. Division of General Surgery, Mount Sinai Hospital, Toronto, ON, Canada

    Rebecca A. Gladdy MD, PhD & Carol J. Swallow MD, PhD

  8. Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Rebecca A. Gladdy MD, PhD & Carol J. Swallow MD, PhD

  9. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Rebecca A. Gladdy MD, PhD & Carol J. Swallow MD, PhD

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  1. Trevor D. Hamilton MD
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  5. Martin E. Blackstein MD, PhD
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  8. Carol J. Swallow MD, PhD
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Correspondence to Carol J. Swallow MD, PhD.

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Hamilton, T.D., Cannell, A.J., Kim, M. et al. Results of Resection for Recurrent or Residual Retroperitoneal Sarcoma After Failed Primary Treatment. Ann Surg Oncol 24, 211–218 (2017). https://doi.org/10.1245/s10434-016-5523-6

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  • DOI: https://doi.org/10.1245/s10434-016-5523-6

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