Recurrence and survival analysis of resected soft tissue sarcomas of pelvic retroperitoneal structures

J Surg Oncol. 2016 Jan;113(1):103-7. doi: 10.1002/jso.24090. Epub 2016 Jan 6.

Abstract

Background: The purpose is to determine the clinicopathologic factors related to survival and recurrence of primary resected pelvic soft tissue sarcomas (STS).

Methods: Demographic/clinical variables were recorded.

Results: Thirty-five pts were identified. Median follow-up was 24.2 months. There were 23 (65.7%) high/intermediate-grade and 12 (34.3%) low-grade tumors included in the final analysis. Eight patients (22.9%) received neoadjuvant therapy. Margins were grossly negative in 27 (77.1%, 17-R0, 10-R1) and grossly positive (R2) in 8 (22.9%). Adjuvant therapy was used in 13 patients (37.1%). The 2- and 3-year RFS was 56.5% and 51.3%, with 14 patients recurring at a median time of 16 months (6-local, 8-distant). All distant recurrences were in high-grade tumors. There were no differences in RFS for margins (R0 vs. R1), neoadjuvant/adjuvant therapy, size (≥10 vs. <10 cm) or gender. High/intermediate-grade tumors had worse RFS (P < 0.008). The 2- and 3-year OS was 80.9%. OS was improved for R0/R1 resection (P < 0.001). Resection to R0/R1 margin was a significant predictor of improved OS (P = 0.001).

Conclusions: High/intermediate-grade lesions were associated with worse OS and RFS. Resection to gross negative margins was the only independent predictor of OS. Adjuvant therapy may be reserved for high-grade lesions due to increased metastatic potential. J

Keywords: clinicopathologic factors; neoadjuvant therapy; resection margins.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chemotherapy, Adjuvant
  • Confounding Factors, Epidemiologic
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / therapy*
  • Pelvic Neoplasms / mortality*
  • Pelvic Neoplasms / pathology
  • Pelvic Neoplasms / surgery*
  • Pelvic Neoplasms / therapy
  • Predictive Value of Tests
  • Radiotherapy, Adjuvant
  • Retroperitoneal Neoplasms / mortality*
  • Retroperitoneal Neoplasms / pathology
  • Retroperitoneal Neoplasms / surgery*
  • Retroperitoneal Neoplasms / therapy
  • Retrospective Studies
  • Risk Factors
  • Sarcoma / mortality*
  • Sarcoma / pathology
  • Sarcoma / surgery*
  • Sarcoma / therapy