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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2021

01-03-2021 | Sarcoma | Sarcoma

Has the Outcome for Patients Who Undergo Resection of Primary Retroperitoneal Sarcoma Changed Over Time? A Study of Time Trends During the Past 15 years

Authors: Dario Callegaro, MD, Chandrajit P. Raut, MD, MSc, Deanna Ng, MD, Dirk C. Strauss, MD, Charles Honoré, MD, PhD, Eberhard Stoeckle, MD, Sylvie Bonvalot, MD, PhD, Rick L. Haas, MD, PhD, Nikolaos Vassos, MD, Lorenzo Conti, MD, Rebecca A. Gladdy, MD, PhD, Mark Fairweather, MD, Winan van Houdt, MD, PhD, MSc, Yvonne Schrage, MD, Frits van Coevorden, MD, PhD, Piotr Rutkowski, MD, PhD, Rosalba Miceli, PhD, Alessandro Gronchi, MD, Carol J. Swallow, MD, PhD

Published in: Annals of Surgical Oncology | Issue 3/2021

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Abstract

Background

This study aimed to investigate changes in treatment strategy and outcome for patients with primary retroperitoneal sarcoma (RPS) undergoing resection at referral centers during a recent period.

Methods

The study enrolled consecutive adult patients with primary non-metastatic RPS who underwent resection with curative intent between 2002 and 2017 at 10 referral centers. The patients were grouped into three periods according to date of surgery: t1 (2002–2006), t2 (2007–2011), and t3 (2012–2017). Five-year overall survival (OS), disease-specific survival (DSS), and crude cumulative incidence (CCI) of local recurrence (LR) and distant metastasis (DM) were calculated. Multivariable analyses for OS and DSS were performed.

Results

The study included 1942 patients. The median follow-up period after resection varied from 130 months (interquartile range [IQR], 124–141 months) in t1 to 37 months (IQR, 35–39 months) in t3. The 5-year OS was 61.2% (95% confidence interval [CI], 56.4–66.3%) in t1, 67.0% (95 CI, 63.2–71.0%) in t2, and 71.9% (95% CI, 67.7–76.1%) in t3. The rate of macroscopically incomplete resection (R2) was 7.1% in t1 versus 4.7% in t3 (p = 0.066). The median number of resected organs increased over time (p < 0.001). In the multivariable analysis resection during t3 was associated with better OS and DSS. The 90-day postoperative mortality improved over time (4.3% in t1 to 2.3% in t3; p = 0.031). The 5-year CCI of LR and DM did not change significantly over time.

Conclusions

The long-term survival of patients who underwent resection for primary RPS has increased during the past 15 years. This increased survival is attributable to better patient selection for resection, quality of surgery, and perioperative patient management.
Appendix
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Metadata
Title
Has the Outcome for Patients Who Undergo Resection of Primary Retroperitoneal Sarcoma Changed Over Time? A Study of Time Trends During the Past 15 years
Authors
Dario Callegaro, MD
Chandrajit P. Raut, MD, MSc
Deanna Ng, MD
Dirk C. Strauss, MD
Charles Honoré, MD, PhD
Eberhard Stoeckle, MD
Sylvie Bonvalot, MD, PhD
Rick L. Haas, MD, PhD
Nikolaos Vassos, MD
Lorenzo Conti, MD
Rebecca A. Gladdy, MD, PhD
Mark Fairweather, MD
Winan van Houdt, MD, PhD, MSc
Yvonne Schrage, MD
Frits van Coevorden, MD, PhD
Piotr Rutkowski, MD, PhD
Rosalba Miceli, PhD
Alessandro Gronchi, MD
Carol J. Swallow, MD, PhD
Publication date
01-03-2021
Publisher
Springer International Publishing
Keyword
Sarcoma
Published in
Annals of Surgical Oncology / Issue 3/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-09065-6

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