Details

Autor(en) / Beteiligte

• MacNeill, Andrea J.
• Miceli, Rosalba
• Strauss, Dirk C.
• Bonvalot, Sylvie
• Hohenberger, Peter
• Coevorden, Frits
• Rutkowski, Piotr
• Callegaro, Dario
• Hayes, Andrew J.
• Honoré, Charles
• Fairweather, Mark
• Cannell, Amanda
• Jakob, Jens
• Haas, Rick L.
• Szacht, Milena
• Fiore, Marco
• Casali, Paolo G.
• Pollock, Raphael E.
• Raut, Chandrajit P.
• Gronchi, Alessandro
• Swallow, Carol J.

Titel

Post‐relapse outcomes after primary extended resection of retroperitoneal sarcoma: A report from the Trans‐Atlantic RPS Working Group

Ist Teil von

• Cancer, 2017-06, Vol.123 (11), p.1971-1978

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2017

Quelle

Electronic Journals Library

Beschreibungen/Notizen

• BACKGROUND Despite a radical surgical approach to primary retroperitoneal sarcoma (RPS), many patients experience locoregional and/or distant recurrence. The objective of this study was to analyze post‐relapse outcomes for patients with RPS who had initially undergone surgical resection of their primary tumor at a specialist center. METHODS All consecutive patients who underwent macroscopically complete resection for primary RPS at 8 high volume centers from January 2002 to December 2011 were identified, and those who developed local recurrence (LR) only, distant metastasis (DM) only, or synchronous local recurrence and distant metastasis (LR+DM) during the follow‐up period were included. Overall survival (OS) was calculated for all groups, as was the crude cumulative incidence of a second recurrence after the first LR. Multivariate analyses for OS were performed. RESULTS In an initial series of 1007 patients with primary RPS, 408 patients developed recurrent disease during the follow‐up period. The median follow‐up from the time of recurrence was 41 months. The median OS was 33 months after LR (n = 219), 25 months after DM (n = 146), and 12 months after LR+DM (n = 43), and the 5‐year OS rates were 29%, 20%, and 14%, respectively. Predictors of OS after LR were the time interval to LR and resection of LR, while histologic grade approached significance. For DM, significant predictors of OS were the time interval to DM and histologic subtype. The subgroup of patients who underwent resection of recurrent disease had a longer median OS than patients who did not undergo resection. CONCLUSIONS Relapse of RPS portends high disease‐specific mortality. Patients with locally recurrent or metastatic disease should be considered for resection. Cancer 2017;123:1971–1978. © 2017 American Cancer Society. In this multi‐institutional series of 408 patients with recurrent retroperitoneal sarcoma treated at specialist centers, relapse is shown to be associated with considerable disease‐specific mortality, with 5‐year overall survival ranging from 12% to 28% according to the pattern of failure. Select patients with recurrent or metastatic disease should be considered for resection.