In:
Journal of Surgical Oncology, Wiley, Vol. 118, No. 8 ( 2018-12), p. 1318-1325
Abstract:
Despite surgery, many patients experience locoregional recurrence (LR), the optimum treatment of which is still debated. Methods All 297 consecutive patients operated for a nonmetastatic primary retroperitoneal soft tissue sarcoma (RPS) between 1994 and 2017 were retrospectively analyzed to report our experience in treating LR. Results After a median follow‐up of 97 months, 55 patients (19%) developed LR. The first site of recurrence was locoregional in 100% with associated peritoneal metastases in 45% and distant metastases in 5%. After LR treatment, the 1‐, 3‐, and 5‐year overall survival (OS) rates were 71%, 46%, and 33%. Low tumor grade, disease‐free interval above 24 months, exclusive LR, and well‐differentiated liposarcoma were predictive of better OS. The treatment strategy (best supportive care, chemotherapy radiotherapy, and/or surgery) was not statistically significant. Fourteen patients underwent initial surveillance (strategic delay) for low‐grade LR and eventually required treatment in 86% after a median delay of 20 months during which no patient developed distant metastases. Conclusions The management of LR in RPS is complex. An initial surveillance may not alter survival in asymptomatic low‐grade and slow‐growing LR. An LR decision scheme is proposed.
Type of Medium:
Online Resource
ISSN:
0022-4790
,
1096-9098
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
82063-5
detail.hit.zdb_id:
1475314-5
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