Abstract 3993
Background
Retroperitoneal soft tissue sarcomas (RPS) are rare tumors. Despite surgery, 5% to 36% of patients experience locoregional recurrence (LR) the optimum treatment of which is still debated. The aim the study of to report our experience in treating LR.
Methods
All 297 consecutive patients operated for a non-metastatic primary RPS between 1994 and 2017 were retrospectively analyzed to identify patients who developed LR. Demographic data, treatment variables and long-term outcome were recorded to calculate disease free survival (DFS), overall survival (OS) and predictive factors of recurrence.
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%. The median disease free interval (DFI) was 24 months. After recurrence treatment, the 1-, 3- and 5-year OS rates were 71%, 46% and 33%, and 1-, 3- and 5-year DFS rates were 50%, 22%, and 15%. Low tumor grade, DFI above 24 months, exclusive LR and well-differentiated liposarcoma were predictive of better OS and DFS. Despite finding no statistical difference between treatment strategies, median OS was less than 1 month after best supportive care, 44 months after chemotherapy (including patients who underwent subsequent LR radiotherapy or surgery) and was not reached after upfront surgery or radiotherapy. Fourteen patients underwent initial surveillance for low-grade liposarcoma 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. A LR decision scheme is proposed.
Clinical trial identification
Legal entity responsible for the study
Gustave Roussy.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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