Primary and recurrent retroperitoneal sarcoma: factors affecting survival and long-term outcome.

Background/aims: To analyze treatment and survival in a series of 39 patients with primary or recurrent retroperitoneal sarcoma treated and prospectively followed at a single institution.

Methodology: Between July 1994 and January 2002, 39 patients (20M, 19F; mean age: 56 years, range: 25-77) were evaluated.

Results: Thirty-two out of 39 patients (82%) (18 were affected by primary retroperitoneal sarcoma, and 14 by recurrent retroperitoneal sarcoma), were submitted for resection. Twenty-four out of 32 patients (75%) underwent removal of contiguous intra-abdominal organs. Peroperative mortality was nil and significant peroperative complications occurred in 6 cases only (19%). High tumor grade results were a significant variable for a worse survival in all 32 patients (100% 5 years survival for low grade vs. 0% for high grade; P=0.0004). Among 27 radically resected patients, only histology gradeand peroperative blood transfusions affected survival (100% 5-year survival for low grade vs. 24% for high grade; P=0.003); (100% 5-year survival for nontransfused patients vs. 43% for transfused patients; P=0.03). Similar effects were noted for disease-free survival.

Conclusions: Histology grade and peroperative blood transfusions were the only factors which affected overall and disease-free survival. An aggressive surgical approach in both primary and recurrent retroperitoneal sarcoma is associated with long-term survival.