Retroperitoneal Sarcomas: Does Laterality Matter?

J Surg Res. 2019 Dec:244:34-41. doi: 10.1016/j.jss.2019.05.016. Epub 2019 Jul 3.

Abstract

Background: Sarcomas are malignant tumors of connective tissue that can vary widely in etiology. Parameters such as grade, extent of resection, and tumor integrity have been shown to affect prognosis. Our principal aim was to examine associations between the laterality of retroperitoneal sarcomas and tumor characteristics, treatment, and patient outcomes.

Materials and methods: We performed a retrospective study of patients treated at our tertiary referral center with a diagnosis of primary retroperitoneal sarcoma who underwent tumor resection. Categorical variables were compared using the chi-square test, whereas continuous variables were compared using one-way analysis of variance. Cox regression was used to estimate the risk of death.

Results: Data from 106 patients were analyzed. A greater proportion of bilateral or midline tumors were leiomyosarcomas (P = 0.02), whereas right-sided tumors were more likely to be liposarcoma (P = 0.02). There was no significant relationship between laterality and tumor grade or stage. Two-thirds of patients had at least one contiguous organ resected (n = 68, 65.4%). Patients with nephrectomy during sarcoma resection were more likely to have right-sided disease (P = 0.02). Splenectomy and pancreatectomy were associated with left-sided disease (P < 0.01; P < 0.01), and pancreaticoduodenectomies with bilateral or midline disease (P < 0.001). Adjusting for age, sex, race, grade, stage, histology, and treatment, there was no increased risk of death or recurrence based on laterality.

Conclusions: Although laterality did not seem to have a measurable relationship with patient outcomes or survival, there was a significant association between laterality, tumor histology, and resection of contiguous organs. These preliminary findings warrant further investigation.

Keywords: Retroperitoneal sarcoma; Soft tissue sarcoma; Surgery.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Female
  • Humans
  • Leiomyosarcoma / mortality*
  • Leiomyosarcoma / pathology
  • Leiomyosarcoma / surgery
  • Liposarcoma / mortality*
  • Liposarcoma / pathology
  • Liposarcoma / surgery
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / prevention & control
  • Nephrectomy / statistics & numerical data
  • Pancreatectomy / statistics & numerical data
  • Pancreaticoduodenectomy / statistics & numerical data
  • Prognosis
  • Retroperitoneal Neoplasms / mortality*
  • Retroperitoneal Neoplasms / pathology
  • Retroperitoneal Neoplasms / surgery
  • Retroperitoneal Space / pathology*
  • Retroperitoneal Space / surgery
  • Retrospective Studies
  • Splenectomy / statistics & numerical data
  • Treatment Outcome