Aim To present the experience from collective data regarding patients with retroperitoneal sarcomas that have been operated in and followed up by the University General Hospital of Patras in Rion, Greece, between 2009 and 2020. Methods A retrospective analysis of adult patients treated at our hospital with a diagnosis of primary retroperitoneal sarcoma who underwent tumour resection. Results Data from 29 patients were analysed. The mean age at diagnosis was 56.1 years; 55.2% of patients were male (n=16). Liposarcomas (on histology) were identified in 19 (65.5%) patients, leiomyosarcoma six (20.7%), and other histologic subtypes in four (13.8%) patients. Tumours >5cm were presented in 27 (93.1%) patients. Negative margins were attained in 13 (44.8%) of all patients who underwent surgical resection. Five (17.2%) patients received neoadjuvant radiation, four (13.8%) postoperative radiation, and three (10.3%) patients received both chemotherapy and radiation prior to surgery with the rest of the patients being treated with surgical excision alone. A 3-year follow-up was successful in 21 (72.4%) patients; five (23.8%) patients died. In total, 16 (55.2%) patients were found to have a local recurrence, with no significant difference in patients' age, gender, tumour size, histology, negative surgical margin (Ro) resection, neoadjuvant chemotherapy, or radiation therapy. There was a significant difference in the 3-year survival rate between patients having positive or negative surgical margins (p=0.027). Conclusion The higher 3-year survival rate in patients with retroperitoneal sarcomas when achieving Ro resection warrant further investigation with a larger sample size across different institutions.
Mullinax J, Zager J, Gonzalez R. Current diagnosis and management of retroperitoneal sarcoma. Cancer Control. 2011. p. 177–87.
2.
Tattersall H, Callegaro D, Ford S, Gronchi A. Staging, nomograms and other predictive tools in retroperitoneal soft tissue sarcoma. Chin Clin Oncol. 2018. p. 36.
3.
Sassa N. Retroperitoneal tumors: review of diagnosis and management. Int J Urol. 2020. p. 1058–70.
4.
Carbone F, Pizzolorusso A, Lorenzo D, G, Marzo D, Cannella M, et al. Multidisciplinary management of retroperitoneal sarcoma: diagnosis, prognostic factors and treatment. Cancers (Basel). p. 4016.
5.
Mulita F, Mukkamalla S. Lymph Node Dissection. StatPearls [Internet]. Treasure Island (FL). StatPearls Publishing; 2022.
6.
Mulita F, Verras G, Liolis E, Tchabashvili L, Kehagias D, Kaplanis C, et al. Recurrent retroperitoneal liposarcoma: a case report and literature review. Clin Case Rep. 2021. p. 4717.
7.
Improta L, Tzanis D, Bouhadiba T, Abdelhafidh K, Bonvalot S. Overview of primary adult retroperitoneal tumours. Eur J Surg Oncol. 2020. p. 1573–9.
8.
Matthyssens L, Creytens D, Ceelen W. Retroperitoneal liposarcoma: current insights in diagnosis and treatment. Front Surg. 2015. p. 4.
9.
Vijay A, Ram L. Retroperitoneal liposarcoma: a comprehensive review. Am J Clin Oncol. 2015. p. 213–9.
10.
Guzzo T, Malkowicz B, S. Retroperitoneal diseases. Penn Clin Man Urol. 2007. p. 653–64.
11.
Mulita F, Lampropoulos C, Kehagias D, Verras G, Tchabashvili L, Kaplanis C, et al. Long-term nutritional deficiencies following sleeve gastrectomy: a 6-year singlecentre retrospective study. Prz Menopauzalny. 2021. p. 170–6.
12.
Messiou C, Moskovic E, Vanel D, Morosi C, Benchimol R, Strauss D, et al. Primary retroperitoneal soft tissue sarcoma: Imaging appearances, pitfalls and diagnostic algorithm. Eur J Surg Oncol. 2017. p. 1191–8.
13.
Crowe P. A retroperitoneal mass needs respect. ANZ J Surg. 2018. p. 261–2.
14.
Shiraev T, Pasricha S, Choong P, Schlicht S, Van Rijswijk C, Dimmick S, et al. Retroperitoneal sarcomas: a review of disease spectrum, radiological features, characterisation and management. J Med Imaging Radiat Oncol. 2013. p. 687–700.
15.
Gyorki D, Choong P, Slavin J, Henderson M. Importance of preoperative diagnosis for management of patients with suspected retroperitoneal sarcoma. ANZ J Surg. 2018. p. 274–7.
16.
Messiou C, Morosi C. Imaging in retroperitoneal soft tissue sarcoma. J Surg Oncol. 2018. p. 25–32.
17.
Mulita F, Parchas N, Germanos S, Papadoulas S, Maroulis I. Case report of a local recurrence of spindle cell embryonal rhabdomyosarcoma. Med Arch. 2020. p. 240–2.
18.
Van Houdt W, Schrijver A, Cohen-Hallaleh R, Memos N, Fotiadis N, Smith M. Needle tract seeding following core biopsies in retroperitoneal sarcoma. Eur J Surg Oncol. 2017. p. 1740–5.
19.
Kirane A, Crago A. The importance of surgical margins in retroperitoneal sarcoma. J Surg Oncol. 2016. p. 270–6.
20.
Stahl J, Corso C, Park H, Rutter A, Han C, Roberts D, et al. The effect of microscopic margin status on survival in adult retroperitoneal soft tissue sarcomas. Eur J Surg Oncol. 2017. p. 168–74.
21.
Wang J, Grignol V, Gronchi A, Luo C, Pollock R, Tseng W. Surgical management of retroperitoneal sarcoma and opportunities for global collaboration. Chin Clin Oncol. 2018. p. 39.
22.
Pham V, Henderson-Jackson E, Doepker M, Caracciolo J, Gonzalez R, Druta M, et al. Practical issues for retroperitoneal sarcoma. Cancer Control. 2016. p. 249–64.
23.
Fevre C Le, Waissi W, Chambrelant I, Noel G, Antoni. A critical narrative review of radiotherapy for retroperitoneal soft tissue sarcoma. Chinese Clin Oncol. 2020. p. 79.
24.
Trovik L, Ovrebo K, Almquist M, Haugland H, Rissler P, Eide J, et al. Adjuvant radiotherapy in retroperitoneal sarcomas. A Scandinavian Sarcoma Group study of 97 patients. Acta Oncol. 2014. p. 1165–72.
25.
Bonvalot S, Gronchi A, Péchoux L, Swallow C, Strauss C, Meeus D, et al. Preoperative radiotherapy plus surgery versus surgery alone for patients with primary retroperitoneal sarcoma (EORTC-62092: STRASS): a multicentre, open-label. Lancet Oncol. 2020. p. 1366–77.
26.
Nussbaum D, Rushing C, Lane W, Cardona D, Kirsch D, Peterson B. Blazer DG 3rd. Preoperative or postoperative radiotherapy versus surgery alone for retroperitoneal sarcoma: a case-control, propensity score-matched analysis of a nationwide clinical oncology database. Lancet Oncol. 2016. p. 966–75.
27.
Gyorki D, Brennan M. Management of recurrent retroperitoneal sarcoma. J Surg Oncol. 2014. p. 53–9.
28.
Gronchi A, Strauss D, Miceli R, Bonvalot S, Swallow C, Hohenberger P, et al. Variability in patterns of recurrence after resection of primary retroperitoneal sarcoma (RPS): a report on 1007 patients from the multi-institutional Collaborative RPS Working Group. Ann Surg. 2016. p. 1002–9.
29.
Van Houdt W, Zaidi S, Messiou C, Thway K, Strauss D, Jones R. Treatment of retroperitoneal sarcoma: current standards and new developments. Curr Opin Oncol. 2017. p. 260–7.
30.
Garcia-Ortega D, Villa-Zepeda O, Martinez-Said H, Cuellar-Hübbe M, Ortiz L, K. Oncology outcomes in retroperitoneal sarcomas: prognostic factors in a retrospective cohort study. Int J Surg. 2016. p. 45–9.
31.
Novak M, Perhavec A, Povšic K, Arnuš M, Eržen M, D. Primary localized retroperitoneal sarcomas: report from Slovenian sarcoma referral center. World J Surg Oncol. 2020. p. 277.
32.
Giuliano K, Nagarajan N, Canner J, Wolfgang C, Bivalacqua T, Terezakis S, et al. Predictors of improved survival for patients with retroperitoneal sarcoma. Surgery. 2016. p. 1628–35.
33.
Callegaro D, Miceli R, Gladdy R. Prognostic models for RPS patients-attempting to predict patient outcomes. J Surg Oncol. 2018. p. 69–78.
34.
Mulita F, Oikonomou N, Tchabashvili L, Liolis E, Kehagias I. A giant ovarian mucinous tumor in a 58-year-old postmenopausal patient with persistent abdominal pain and high serum levels of CA 19-9. Pan Afr Med J. 2020. p. 76.
35.
Fairweather M, Gonzalez R, Strauss D, Raut C. Current principles of surgery for retroperitoneal sarcomas. J Surg Oncol. 2018. p. 33–41.
36.
Mulita F, Liolis E, Kehagias D, Tchabashvili L, Kaplanis C, Iliopoulos F, et al. An enormous pelvic tumor in a 46-year-old woman with an elevated serum CA 125 level, what lies beneath it? Investigation of uterine tumors in postmenopausal women. Prz Menopauzalny. 2021. p. 154–7.
37.
Mulita F, Iliopoulos F, Kehagias I. A rare case of gastric-type mucinous endocervical adenocarcinoma in a 59-year-old woman. Prz Menopauzalny. 2020. p. 147–50.
38.
Tyler R, Lee M, Ierodiakonou V, Hodson J, Taniere P, Almond M, et al. Prognostic implications of histological organ involvement in retroperitoneal sarcoma. BJS Open. 2021. p. 80.
39.
Fairweather M, Raut C. Nephrectomy for retroperitoneal sarcoma: stay calm and (cautiously) carry on. Ann Surg Oncol. 2021. p. 1275–7.
40.
Berger N, Silva J, Mogal H, Clarke C, Bedi M, Charlson J, et al. Overall survival after resection of retroperitoneal sarcoma at academic cancer centers versus community cancer centers: An analysis of the National Cancer Data Base. Surgery. 2018. p. 318–23.
41.
Liles J, Tzeng C, Short J, Kulesza P, Heslin M. Retroperitoneal and intra-abdominal sarcoma. Curr Probl Surg. 2009. p. 445–503.
42.
Du G, Zhang Z, Wen X, Yu C, Calway T, Yuan C, et al. Epigallocatechin Gallate (EGCG) is the most effective cancer chemopreventive polyphenol in green tea. Nutrients. 2012. p. 1679–91.
43.
Kwong M, Lee B, Kunihira K, Sutjiadi B, Reeves M, Selleck M, et al. Treatment factors associated with overall survival in retroperitoneal sarcoma: an institutional review. Am Surg. 2020. p. 1358–62.
44.
Macneill A, Van Houdt W, Swallow C, Gronchi A. Management of metastatic retroperitoneal sarcoma: a consensus approach from the Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG). Ann Oncol. 2018. p. 857–71.
45.
Ma S, Oladeru O, Farrugia M, Shekher R, Iovoli A, Singh A. Evaluation of preoperative chemotherapy or radiation and overall survival in patients with nonmetastatic, resectable retroperitoneal sarcoma. JAMA Netw Open. 2020.
46.
Livingston J, Bugano D, Barbo A, Lin H, Madewell J, Wang W, et al. Role of chemotherapy in dedifferentiated liposarcoma of the retroperitoneum: defining the benefit and challenges of the standard. Sci Rep. 2017. p. 11836.
47.
Almond L, Gronchi A, Strauss D, Jafri M, Ford S, Desai A. Neoadjuvant and adjuvant strategies in retroperitoneal sarcoma. Eur J Surg Oncol. 2018. p. 571–9.
48.
Constantinidou A, Jones R. Systemic therapy in retroperitoneal sarcoma management. J Surg Oncol. 2018. p. 87–92.
49.
Seidensaal K, Kieser M, Hommertgen A, Jaekel C, Harrabi S, Herfarth K, et al. Neoadjuvant irradiation of retroperitoneal soft tissue sarcoma with ions (Retro-Ion): study protocol for a randomized phase II pilot trial. Trials. 2021. p. 134.
50.
Sargos P, Stoeckle E, De Figueiredo H, Antoine B, Delannes M, Mervoyer M, et al. Radiotherapy for retroperitoneal sarcomas. Cancer Radiother. 2016. p. 677–84.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
,
