Surgery and postoperative radiation therapy in primary retroperitoneal sarcomas: Experience of the cancer centre Alexis-Vautrin [Intérêt de la radiothérapie postopératoire dans la prise en charge des sarcomes rétropéritonéaux primitifs: expérience du centre Alexis-Vautrin]

摘要

Purpose: Surgical resection remains the standard treatment for patients with resectable retroperitoneal sarcomas. The aim of this study was to retrospectively analyse the outcomes of patients with primary retroperitoneal sarcoma. Patients and methods: We analysed data of 50 patients with primary retroperitoneal sarcoma who underwent curative-intent resection from 1975 to 2008. External beam radiotherapy and chemotherapy were delivered postoperatively. Demographics, surgical, pathological variables and chemo/radiation therapy were analysed as prognosis factors. Results: There were 22 males and 28 females (mean age 54. ±. 13. years). Surgery required visceral resections in 30 patients. There were 16 leiomyosarcomas, 25 liposarcomas and eight other sub-types. Twenty-one patients had clear surgical margins. Twenty-eight patients received postoperative external beam radiotherapy (median 45. Gy) and 15 received chemotherapy. At the end of the follow-up (median 55. months), local recurrence occurred in 39% (. n=. 14) among R0/R1 resection group (. n=. 36). Postoperative external beam radiotherapy tends to increase the time of local recurrence from surgery (27 vs. 13. months, . P=. 0.05). The overall survival rates were 81%, 55% and 46% at 1, 3 and 5. years, respectively. Although R0 resection (. P=. 0.01), well tumour differentiation (. P=. 0.004) and postoperative external beam radiotherapy (. P=. 0.02) significantly influenced overall survival in univariate analysis, only R0 resection was an independent prognostic factor in a multivariate analysis. Conclusion: We confirm the pre-eminence of radical surgery with negative margins as major prognostic factor and the benefit of postoperative radiotherapy.