Abstract
Sarcomas are uncommon malignant tumors arising from mesenchymal tissue, accounting for approximately 10% of soft-tissue sarcomas and less than 1% of all malignant neoplasms. The most frequent subtypes of retroperitoneal sarcomas are liposarcoma. Total surgical extirpation appears the only chance for patient cure since medical therapies have shown little efficacy. We have analyzed our series of 32 retroperitoneal liposarcoma that undergone surgical resection and with at least 5 years of follow-up. We have included 21 patients who underwent a complete resection (R0) and 6 patients who underwent an incomplete resection (R1). However, the operation’s goal was a complete tumor resection with tumor-free resection margins. The 5-year survival was 85.7% when we performed a R0 resection, while it was 33.3% when we performed a R1 resection with a significant statistical difference (p = 0.02). Surgery is the gold standard for treatment of liposarcoma. Despite advances in diagnostic modalities, surgical techniques and the adoption of more aggressive procedure, such disease still has a propensity for local recurrence, even after an apparent complete resection. Therefore, locoregional recurrence remains the main cause of death in patients with a retroperitoneal liposarcoma. Moreover when the tumor recurs locally, the treatment of choice is to remove the recurrence. Our experience shows that a complete resection of primary lesions and further resection of recurrences early detected with CT examination could improve the overall survival of patients with retroperitoneal liposarcoma. Moreover in our series, the patients who undergo R1 resection had a worse prognosis.
Similar content being viewed by others
References
Storm FK, Mahvi DM (1991) Diagnosis and management of retroperitoneal soft tissue sarcomas. Ann Surg 214:2–10
Hassan I, Park SZ, Donohue JH, Nagorney DM, Kay PA, Nasciemento AG, Schleck CD, Ilstrup DM (2004) Operative management of primary retroperitoneal sarcomas. a reappraisal of an institutional experience. Ann Surg 239(2):244–250
Jaques DP, Coit DG, Hajdu SI, Brenan MF (1990) Management of primary and recurrent softtissue sarcoma of the retroperitoneum. Ann Surg 212(1):51–59
Lewis JJ, Brennan MF (1996) Soft tissue sarcomas. Curr Probl Surg 33(10):817–872
Gholami S, Jacobs CD, Kapp DS, Parast LM, Norton JA (2009) The value of surgery for retroperitoneal sarcoma. Sarcoma. Article ID:605840 [Epub ahead of print]
Lewis JJ, Leung D, Woodruff JM, Brennan MF (1998) Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution. Ann Surg 228:355–365
Herrera-Gomez A, Ortega-Gutiérrez C, Mohar Betancourt A, Luna-Ortiz K (2008) Giant retroperitoneal liposarcma. World J surg Oncol 6:115
Sugarbaker PH (2001) Management of abdominopelvic sarcoma. In: Malawer MM, Sugarbaker PH (eds) Musculoskeletal cancer surgery treatment of sarcomas and allied diseases. Kluwer Academic Publishers, pp 147–163
Doglietto GB, Tortorelli AP, Papa V, Rosa F, Bossola M, Prete FP, Covino M, Pacelli F (2007) Giant retroperitoneal sarcomas: a single institution experience. World J Surg 31(5):1047–1054
Di Matteo FM, De Stefano M, Vanni B, Palermo S, Biancafarina A, Giusti D, Giusti D, Savino G, Di Marco C, Casalvieri L, De Antoni E (2008) Retroperitoneal giant mixed sarcoma. Case report. G Chir 29(5):238–241
An JY, Heo JS, Noh JH, Sohn TS, Nam SJ, Choi SH, Joh JW, Kim SJ (2007) Primary malignant retroperitoneal tumors: analysis of a single institutional experience. Eur J Surg Oncol 33(3):376–382
Fleming ID, Cooper JS, Henson DE, Hutter RVP (eds) (1997) American Joint Committee on Cancer Manual for Staging of Cancer. 5th edn, J.P. Lippincott, Philadelphia 149–1156
Shiu MH, Brennan MF (eds) (1989) Surgical management of soft tissue sarcomas. Lea & Febiger, Philadelphia p 166
Glenn J, Sindelar WF, Kinsella T, Glenn J, Sindelar WF, Kinsella T, Glatstein E, Tepper J, Costa J, Baker A, Sugarbaker P, Brennan MF, Seipp C et al (1985) Results of multimodality therapy of resecable soft tissue sarcomas of the retroperitoneum. Surgery 97:316–324
Herman K, Kusv T (1999) Retroperitoneal sarcoma—the continued challenge for surgery and oncology. Surg Oncol 7:77–81
Dalton RR, Donohue JH, Mucha P, van Heerden JA, Reiman HM, Chen SP (1989) Management of retroperitoneal sarcomas. Surgery 106:725–733
Nathan H, Raut CP, Thornton K, Herman JM, Ahuja N, Schulick RD, Choti MA, Pawlik TM (2009) Predictors of survival after resection of retroperitoneal sarcoma: a population-based analysis and critical appraisal of the AJCC staging system. Ann Surg 250(6):970–976
McGrath PC (1994) Retroperitoneal sarcomas. Semin Surg Oncol 10:364–368
Sato T, Yamaguchi T, AzeKura K, Azekura K, Ueno M, Ohyama S, Ohya M, Yamamoto J, Muto T, Ishikawa Y, Kanda H (2006) Repeated resection for intra-abdominal and retroperitoneal liposarcomas: long-term experience in a single cancer center in Japan. Int Surg 91:267–271
Greenall MJ, Magill GB, De Cosse JJ, Brennan MF (1986) Chemioterapy for soft tissue sarcoma. Surg Gynecol Obstet 162:193–198
Thomas DM, O’Sullivan B, Gronchi A (2009) Current concepts and future perspectives in retroperitoneal soft-tissue sarcoma management. Expert Rev Anticancer Ther 9(8):1145–1157
Zhou Z, McDade TP, Simons JP, Ng SC, Lambert LA, Whalen GF, Shah SA, Tseng JF (2010) Surgery and radiotherapy for retroperitoneal and abdominal sarcoma: both necessary and sufficient. Arch Surg 145(5):426–431
Mc Grath PC, Neifeld JP, Lawrence W Jr, DeMay RM, Kay S, Horsley JS, Parker DA (1984) Improved survival following complete excision of retroperitoneal sarcomas. Ann Surg 200:200–204
Strauss DC, Hayes AJ, Thway K, Moskovic EC, Fisher C, Thomas JM (2010) Surgical management of primary retroperitoneal sarcoma. Br J Surg 97(5):698–706
Kim EY, Kim SJ, Choi D, Lee SJ, Kim SH, Lim HK, Song SY (2008) Recurrence of retroperitoneal liposarcoma: imaging findings and growth rates at follow-up CT. AJR 191:1841–1846
Bautista N, Su W, O’Connell TX (2000) Retroperitoneal soft-tissue sarcomas: prognosis and treatment of primary and recurrent disease. Ann Surg 66:832–836
Mantel N, Haenszel W (1959) Statistical aspect of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 22:719–748
Cody HS 3rd, Turnbull AD, Fortner JG, Hajdu SI (1981) The continuing challenge of retroperitoneal sarcomas. Cancer 47:2147–2152
Heslin MJ, Lewis JJ, Nadler E, Newman E, Woodruff JM, Casper ES, Leung D, Brennan MF (1997) Prognostic factors associated with long-term survival for retroperitoneal sarcoma: implications for management. J Clin Oncol 15:2832–2839
Alvarenga JC, Ball AB, Fisher C, Fryatt I, Jones L, Thomas JM (1991) Limitations of surgery in the treatment of retroperitoneal sarcomas. Br J Surg 78:912–916
Kilkenny JW III, Bland KI, Copeland EM III (1996) Retroperitoneal sarcoma: the University of Florida experience. J Am Coll Surg 182:329–339
Karakousis CP, Velez AF, Gerstenbluth R, Driscoll DL (1996) Resecability and survival in retroperitoneal sarcomas. Ann Surg Oncol 3:150–158
Lahat G, Madewell JE, Anaya DA, Qiao W, Tuvin D, Benjamin RS, Lev DC, Pollock RE (2009) Computed tomography scan-driven selection of treatment for retroperitoneal liposarcoma histologic subtypes. Cancer 115(5):1081–1090
Bidault FJ, Vanel D, Athanasiou A, Pigneur F, Lopez I, Petrow P, Sigal R, Bonvalot S (2006) Retroperitoneal sarcomas imaging. Bull Cancer 93(12):1167–1174
Kim EY, Kim SJ, Choi D, Lee SJ, Kim SH, Lim HK, Song SY (2008) Recurrence of retroperitoneal liposarcoma: imaging findings and growth rates at follow-up CT. AJR Am J Roentgenol 191(6):1841–1846
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Milone, M., Pezzullo, L.S., Salvatore, G. et al. Management of high-grade retroperitoneal liposarcomas: personal experience. Updates Surg 63, 119–124 (2011). https://doi.org/10.1007/s13304-011-0061-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13304-011-0061-z