Abstract
BackgroundTo report the effect of intraoperative electron beam radiotherapy (IOERT) and external beam radiotherapy (EBRT) in addition to surgery as well as to evaluate the role of resectable local recurrence for long-term prognosis.MethodsIn 53 patients who underwent surgery for retroperitoneal soft tissue sarcoma (RSTS) from 2001 to 2014 prognostic and epidemiologic factors were reviewed retrospectively to analyze their impact on survival and recurrence.ResultsTwenty three patients (50%) had surgery plus radiotherapy, 23 (50%) had surgery only. Histology showed 73.9% liposarcoma, 15.2% leiomyosarcoma and 6.5% pleomorphic undifferentiated sarcoma respectively. Low grade sarcoma were observed in 52.2%, high grade sarcoma in 47.8%. The latter showed a trend towards a decreased 5-year survival rate (p = 0.125). Margin status was: R0: 60.9%, R1: 23.9%, R2: 15.2%; leading to significant changes in 5-year survival rate (R0: 77.6%; R1: 70.0%; R2: 42.9%; p = 0.03). Age younger than 55 years significantly improved 5-year survival rate (p = 0.039). Patients receiving resection of multiple sarcoma recurrence showed an almost identical improved 5-year survival rate compared to patients without recurrence (no recurrence: 100.0%; single recurrence: 35.0%; multiple recurrence: 91.7%; p = 0.001). Surgery plus radiotherapy led to significantly improved survival (p = 0.04).ConclusionsThere is a significant benefit in terms of 5-year survival after surgery plus some form of radiotherapy and a good prognosis for patients when the recurrence from RSTS was resected. Age older than 55 years and incomplete resection lowered 5-year survival rate significantly.
Highlights
To report the effect of intraoperative electron beam radiotherapy (IOERT) and external beam radiotherapy (EBRT) in addition to surgery as well as to evaluate the role of resectable local recurrence for long-term prognosis
Low-grade-sarcoma was observed in 52.2% of patients while highgrade-sarcoma was observed in 47.8% of patients
N number of patients, Events number of deaths and/or recurrences, 5-YSR 5 year survival rate, Progression Free Survival (PFS) progression free survival, Standard deviation (SD) standard deviation, P p-value, S + Surgery plus radiotherapy (RT) surgery plus radiotherapy, SO surgery only recurrence (91.7% vs. 100.0%; p = 0.317), whereas 5year-survival-rate of patients with a single recurrence was significantly worse in comparison (35.0%0; p = 0.001) (Table 2, Fig. 2)
Summary
To report the effect of intraoperative electron beam radiotherapy (IOERT) and external beam radiotherapy (EBRT) in addition to surgery as well as to evaluate the role of resectable local recurrence for long-term prognosis. Soft-tissue sarcoma are rare tumor entities arising from mesenchymal tissue. There are 3 predominant subtypes: liposarcoma (26–64.5%), leiomyosarcoma (13.2–31%) and pleomorphic undifferentiated sarcoma (PUS) (7–27%) [2,3,4,5,6,7,8,9,10]. Due to their anatomic origin the clinical presentation of RSTS is typically inapparent and characterized by late symptoms and a large tumor size at the time of diagnosis.
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