Aggressive Surgery in Retroperitoneal Soft Tissue Sarcoma Carried Out at High-Volume Centers is Safe and is Associated With Improved Local Control

Median follow-up was 37 months (interquartile [IQ] range, 16–61 months). Median tumor size was 17 cm (IQ range, 11–26 cm). The median number of organs resected en bloc with the tumor was 2 (IQ range, 1–3). Complete macroscopic resection was achieved in 232 cases (93%). At 5 years, overall survival was 65.4% (95% confidence interval [95% CI], 56.8–72.7); local and distant recurrence crude cumulative incidences were 22.3% (95% CI, 16.5–30.2) and 24.2% (95% CI, 18.4–31.9), respectively. Postsurgical morbidity requiring at least one invasive therapeutic procedure was observed in 45 patients (18%; 95% CI, 14–23). Surgical reintervention was necessary in 30 patients (12%; 95% CI, 8–17). Eight patients died of postoperative complications (3%; 95% CI, 1–6). No statistically significant association between postsurgical morbidity and any clinical variable was detected. For number of resected organs, we documented an increased risk of morbidity for more than three organs (P = 0.007). Postsurgical morbidity did not affect oncologic outcome.