Primary localized retroperitoneal sarcomas: report from Slovenian sarcoma referral center
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(2020) 18:277
RESEARCH
Open Access
Primary localized retroperitoneal sarcomas: report from Slovenian sarcoma referral center Marko Novak1* , Andraž Perhavec1, Milena Kerin Povšič2, Matej Arnuš2 and Darja Eržen1
Abstract Background: Sarcoma patients should be treated in high volume referral sarcoma centers. Compartmental resection is proposed as the best treatment option in retroperitoneal sarcoma patients. Methods: Institute of Oncology Ljubljana is the only referral sarcoma center in Slovenia. Having a population of 2.1 million poses a unique situation. We manage all sarcoma patients in the country and operate on patients with soft tissue tumors of extremities, trunk, and abdomen. Data for all consecutive patients surgically treated from January 1999 to December 2018 for primary localized retroperitoneal sarcoma was extracted from a prospective surgical database. Data about the incidence of sarcoma patients in Slovenia was extracted from the Cancer Registry of Republic of Slovenia. Clinicopathologic variables and the outcome were analyzed. Results: In total, 89 patients were included in the study. Median age was 62 years. Dedifferentiated liposarcoma was the most common histology (38.2%). Median tumor size was 21 cm. Compartmental resection was performed in 47.2% (42/89). Postoperative complication grade 3a or higher according to Clavien-Dindo classification had 30.3% (27/89) of patients. The 30-day and 90-day mortality rate was 2.2% and 5.6%. Median follow-up was 62.1 months. Corresponding 5-year overall survival was 67.2%, 5-year disease-specific survival was 72.6%, and 5-year local recurrence-free survival was 81.5%, respectively. Conclusion: Results from our institution show that referral sarcoma centers may achieve very good results in management of retroperitoneal sarcoma patients, despite not meeting the criteria for high volume hospitals, as long as they have multidisciplinary team, appropriate facilities, and expertise. Keywords: Retroperitoneal sarcoma, Referral center, Surgery, Survival
Background Surgery is the mainstay of treatment in primary localized retroperitoneal sarcomas (RPS). Compartmental resection offers the best chance for local control and/or potential cure to the patients [1, 2]. This approach comprises an en bloc resection of tumor with kidney, colon, and psoas fascia or muscle. If other adjacent organs are infiltrated, * Correspondence: [email protected] 1 Department of Surgical Oncology, Institute of Oncology Ljubljana, Zaloška 2, 1105 Ljubljana, Slovenia Full list of author information is available at the end of the article
they are resected en bloc as well comprising multivisceral resection. A benefit of preoperative radiotherapy is still under research; thus, it is not routinely recommended. The EORTC 62092 trial (STRASS) failed to demonstrate the benefit of preoperative radiotherapy in abdominal recurrence of RPS [3]. Final results and publications about the STRASS study are awaited. The role of chemotherapy in RPS has not been investigated in a randomized controlled trial. En
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