Outcome following resection of retroperitoneal sarcoma

Background: Retroperitoneal sarcoma comprises a range of different histological subtypes with dissimilar behaviour and biology. This study sought to characterize the morbidity and mortality associated with multivisceral resection and oncological outcomes according to subtype. Methods: All patients undergoing resection of primary retroperitoneal sarcoma at the Royal Marsden Hospital between January 2005 and December 2014 were identified from a database. Results: Some 362 patients underwent resection, with 292 requiring multivisceral resection. The 30-day mortality rate was 1.4 per cent (5 patients), the 30-day morbidity rate was 15.7 per cent (57 patients), and 27 patients required a return to theatre. Age over 75 years was predictive of 30-day mortality (hazard ratio 1.37, 95 per cent c.i. 1.13 to 1.65). The overall disease-specific survival rate at 3 years was 81.2 per cent. For well differentiated liposarcoma, dedifferentiated liposarcoma and leiomyosarcoma, 3-year local recurrence-free survival rates were 98 (95 per cent c.i. 83 to 99), 56.7 (45.7 to 66.2) and 80 (67 to 89) per cent respectively. At 3 years the distant metastasis-free survival rate was 100, 85.9 (77.4 to 91.4) and 65 (49 to 77) per cent, and the disease-specific survival rate was 97 (89 to 99), 78.5 (74.6 to 82.4) and 79 (63 to 85) per cent for well differentiated liposarcoma, dedifferentiated liposarcoma and leiomyosarcoma respectively. Conclusion: Resection of retroperitoneal sarcoma was associated with a 30-day mortality rate of less than 2 per cent and a morbidity rate of 15.7 per cent. The overall 3-year disease-specific survival rate was 81.2 per cent.