Intraabdominal and retroperitoneal soft-tissue sarcomas - outcome of surgical treatment in primary and recurrent tumors
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RESEARCH
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Intraabdominal and retroperitoneal soft-tissue sarcomas - outcome of surgical treatment in primary and recurrent tumors Ane S Sogaard1, Jacob M Laurberg1, Mette Sorensen1, Ole S Sogaard2, Pal Wara1, Peter Rasmussen3, Soren Laurberg3*
Abstract Background: Surgery is the only curative treatment for intraabdominal and retroperitoneal sarcoma (IaRS). Little is known about how to treat patients with recurrence. We here report the outcome in primary and recurrent sarcoma treated at the Sarcoma Center in Aarhus, Denmark. Methods: All patients evaluated for IaRS from June 1998 to May 2008 were enrolled and data on symptoms, signs, means of diagnosis, extent of surgery, perioperative complications, mortality and long time survival were registered. Primary and first-recurrence sarcomas were analyzed separately. Results: Sixty-five of 73 primary and 22 of 28 first-recurrence IaRS had surgery. Fifty-three (82%) and 11 (50%) patients achieved radical R0 resection. Age and radicality of surgery were independent predictors of death, while recurrence of sarcoma was not. Perioperative mortality was 2.3%. 5-year survival was 70.2% for primary and 51.8% for first-recurrent sarcomas. However, patients with radical surgery had 5-year survival of over 70% in both the primary and recurrent group. Conclusions: The radicality of surgery is the most important prognostic factor. Patients with recurrence have an equally good prognosis as those with primary sarcoma if radicality is achieved and such surgery should not be considered only as a palliative effort.
Background Soft tissue sarcomas are a heterogeneous group of malignant tumors originating from mesenchymal cells. They constitute just under 1% of all cancers [1], corresponding to only 9000 new cases annually in US, and 1500 in UK [1,2]. Approximately 20% of soft tissue sarcomas arise from intraabdominal or retroperitoneal cells [3], and the three most prevalent histopathological types are gastrointestinal stromal tumor (GIST), leiomyosarcoma, and liposarcoma [4-6]. However, any mesenchymal cell, is capable of malignant transformation, and more than 100 different histopathological types of sarcoma have been described [7,8]. Diagnosing intraabdominal and retroperitoneal sarcomas (IaRS) is often difficult since the signs and * Correspondence: [email protected] 3 Sarcoma Center, Aarhus University Hospital, Aarhus, Denmark Full list of author information is available at the end of the article
symptoms are often discreet and uncharacteristic. General symptoms are common, and depending on tumor site, haemorrhage, ascites, pressure symptoms, and pain may be present. Consequently, the diagnosis is often made at an advanced stage when the tumor has reached a considerable size. The final diagnosis is usually made by imaging modalities such as MR-, CT-, or ultrasound scans. It is recommended, that preoperative biopsies are performed using a fine needle because of the risk of spreading through tumor seeding, also considering the puncture ro
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