Surgical outcome and patterns of recurrence for retroperitoneal sarcoma at a single centre
Autor: | Jeremy French, Derek Manas, John Lunec, D Lee, J. Scott, Petra Dildey, H D J Hogg |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Systemic disease medicine.medical_treatment Disease-Free Survival Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Retroperitoneal Neoplasms 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over Analysis of Variance business.industry Soft tissue sarcoma Cancer Sarcoma Retrospective cohort study General Medicine Middle Aged medicine.disease Retroperitoneal Neoplasm Surgery Radiation therapy Treatment Outcome Oncology 030220 oncology & carcinogenesis Female Histopathology Neoplasm Recurrence Local business |
Zdroj: | The Annals of The Royal College of Surgeons of England. 98:192-197 |
ISSN: | 1478-7083 0035-8843 |
Popis: | Introduction Retroperitoneal sarcoma is a surgically managed condition that can recur locally following macroscopically complete resection. Owing to the low incidence of the condition, advances in treatment are reported infrequently but complete compartmental resection and adjuvant or neoadjuvant radiotherapy are areas under investigation. Given the practical difficulty of randomised trials, observational data can highlight advantages from progressive treatment approaches. Methods A retrospective database of consecutive retroperitoneal sarcoma resections performed at a single referral centre between March 1997 and March 2013 was interrogated. Histological, radiological and clinical data were collected. Univariate and multivariate analyses for disease free and overall survival were performed to establish independent predictors of disease recurrence and patient survival. Results A total of 79 patients underwent 90 resections (63 primary). The mean five-year overall and disease free survival rates were 55.3% and 24.8% respectively. Higher patient age, high tumour grade, presence of extraretroperitoneal disease and invasive tumour phenotype were found to significantly predict survival following multivariate analysis. Half (50%) of the tumours displayed invasive behaviour on histopathology and 42% of locoregional recurrence was intraperitoneal. Conclusions Retroperitoneal sarcoma is commonly an infiltrative tumour and often recurs outside of the retroperitoneum. These features limit the therapeutic impact of interventions that focus on gaining local control such as complete compartmental resection and radiotherapy. It seems likely that future advances in the management of this cancer will involve new systemic agents to treat this frequently systemic disease. |
Databáze: | OpenAIRE |
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