Personalizing the Approach to Retroperitoneal Soft Tissue Sarcoma: Histology-specific Patterns of Failure and Postrelapse Outcome after Primary Extended Resection.

[dedifferentiated liposarcoma]

To explore patterns of failure and postrelapse outcome of patients with retroperitoneal sarcoma primarily treated by extended resection .All consecutive patients with primary retroperitoneal sarcoma , treated between January 2002 and December 2011 at two European sarcoma centers were included . Five -year overall survival (OS ) and crude cumulative incidence (CCI ) of local recurrence (LR ) and distant metastases (DM ) were calculated . Multivariate analyses for OS and CCI of LR and DM were performed . Postrelapse OS was investigated .A total of 377 patients were identified . Median follow-up from the time of primary surgery was 44 Â months [interquartile range (IQR ) 27 -82 ]. Five -year OS was 64 Â % [95 Â % confidence interval (CI ) 0 .588 , 0710 ]. CCI of LR and DM were 23 .6 Â % (95 Â % CI 18 .9 , 29 .4 ) and 21 .9 Â % (95 Â % CI 17 .6 , 27 .3 ), respectively . OS , CCI of LR and DM were 87 , 18 Â % and 0 for well-differentiated liposarcoma ; 54 , 44 and 9 Â % for grade II dedifferentiated liposarcoma ; 41 ,33 , and 44 Â % for grade III dedifferentiated liposarcoma ; 58 , 5 , and 55 Â % for leiomyosarcoma ; and 85 , 4 , and 17 Â % for solitary fibrous tumor , respectively . Seventy -six patients developed LR . Median postrelapse follow-up was 27 Â months (IQR 10 -58 ). Twenty -one patients (27 Â %) underwent a second surgical resection (complete in 18 ), while 55 (73 Â %) did not (22 multifocal , 17 inoperable , 16 other causes ). Median postrelapse OS was 17 Â months (IQR 7 -31 ). Well-differentiated liposarcoma histology and disease-free interval predicted postrelapse OS , while surgical resection did not .When primary extended surgery limits LR , histologic subtype and grade determine the outcome . At recurrence , a second surgery is of limited benefit .

Diseases
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Diseases presenting "primary surgery" symptom

dedifferentiated liposarcoma

liposarcoma

well-differentiated liposarcoma

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