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Annals of Surgical Oncology

, Volume 26, Issue 11, pp 3535–3541 | Cite as

Intraperitoneal Invasion of Retroperitoneal Sarcomas: A Risk Factor for Dismal Prognosis

  • Eran Nizri
  • Marco Fiore
  • Francesco Barretta
  • Chiara Colombo
  • Stefano Radaelli
  • Dario Callegaro
  • Roberta Sanfilippo
  • Claudia Sangalli
  • Paola Collini
  • Silvia Stacchiotti
  • Paolo G. Casali
  • Rosalba Miceli
  • Alessandro GronchiEmail author
Sarcoma
  • 70 Downloads

Abstract

Introduction

Retroperitoneal sarcomas (RPS) lie in the retroperitoneal space and are covered by a peritoneal layer. However, some RPS have an intraperitoneal component (IPC), which invades into the peritoneal cavity. The significance of such a clinical presentation is unknown.

Methods

We retrospectively analyzed our prospectively maintained institutional database of RPS, along with intraoperative photographs taken to document the primary tumor extent at laparotomy. The effects of IPC on overall survival (OS), local recurrence (LR), and distant metastasis (DM) were evaluated.

Results

IPC was present in 81 of 493 patients (16.4%). It was significantly associated with older age (64 vs. 59, p = 0.008), gender (67% vs. 33% males, p = 0.005), and multifocality (11.1% vs. 0.5%; p < 0.0001). IPC was not associated with size or any specific histology, while it showed a weak association with high malignancy grade (40.7% vs. 28.6% in G3 tumors; p = 0.076). At a median follow-up of 32 months IPC was associated with worse 5-year OS (54% vs. 74%, p < 0.001) and crude cumulative incidence (CCI) of LR (5-year CCI of LR: 38% vs. 19%, p = 0.001), but not to CCI of DM. However, multivariable models showed that IPC’s effect on OS (HR: 1.52, 95% CI 0.92–2.49, p = 0.1) and LR (HR: 1.34, 95% CI 0.8–2.26, p = 0.27) could be sufficiently explained by other known risk factors.

Conclusions

IPC is associated with increased LR and decreased survival. However, the effect of IPC on prognosis is predominantly related to other tumor characteristics already included in published nomograms. IPC should not be a contraindication to a proper surgical resection.

Notes

Disclosure

The authors have nothing to disclose.

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Eran Nizri
    • 1
    • 2
  • Marco Fiore
    • 1
  • Francesco Barretta
    • 3
  • Chiara Colombo
    • 1
  • Stefano Radaelli
    • 1
  • Dario Callegaro
    • 1
  • Roberta Sanfilippo
    • 4
  • Claudia Sangalli
    • 5
  • Paola Collini
    • 6
  • Silvia Stacchiotti
    • 3
  • Paolo G. Casali
    • 4
    • 7
  • Rosalba Miceli
    • 3
  • Alessandro Gronchi
    • 1
    Email author
  1. 1.Department of SurgeryFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  2. 2.Department of Surgery A, Tel-Aviv Sourasky Medical Center and Sackler Faculty of MedicineTel-Aviv UniversityTel-AvivIsrael
  3. 3.Clinical Epidemiology and Trial OrganizationFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  4. 4.Department of Cancer MedicineFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  5. 5.Department of RadiotherapyFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  6. 6.Department of PathologyFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  7. 7.Oncology and Haemato-Oncology DepartmentUniversity of MilanMilanItaly

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