Prognostic factors associated with long-term survival for retroperitoneal sarcoma: Implications for management Journal Article


Authors: Heslin, M. J.; Lewis, J. J.; Nadler, E.; Newman, E.; Woodruff, J. M.; Casper, E. S.; Leung, D.; Brennan, M. F.
Article Title: Prognostic factors associated with long-term survival for retroperitoneal sarcoma: Implications for management
Abstract: Purpose: Retroperitoneal soft tissue sarcomas are rare tumors. Studies characterizing long-term follow-up and patterns of recurrence are limited. The purpose of this analysis is to identify patterns of recurrence and prognostic factors associated with long-term survival after resection of retroperitoneal soft tissue sarcomas. Methods: Between July 1, 1982, and June 30, 1990, 198 adult patients were identified from our prospective soft tissue sarcoma database carrying the diagnosis of retroperitoneal soft tissue sarcoma who were eligible for ≤5 years of follow-up. Of these, 48 patients (25%) were documented to be alive ≤ 5 years from the time of operation. Statistical analysis was by log-rank or Wilcoxon test for univariate analysis. Multivariate analysis was by the Cox model. Results: The recurrence rate during the follow-up period was approximately 5% per year from the time of initial operation. Of the patients who were disease-free for ≤ 5 years from initial surgery, 40% recurred by 10 years. Radiation therapy was the only factor significant (P = .02) for a reduction in the risk of local recurrence. Age ≤ 50 years and high-grade tumors were significant factors (P= .003 and .009, respectively) for an increased risk of distant metastasis. Incomplete gross resection was the only factor significant for an increased risk of tumor mortality (P = .003). Conclusion: Complete surgical resection at the time of primary presentation is likely to afford the best chance for long-term survival. With long-term follow-up, it is clear that recurrence will continue to occur, and a 5-year disease-free interval is not a cure. Patients with an incomplete initial resection, age less than 50 years, and high-grade tumors are candidates for investigational adjuvant therapy.
Keywords: adult; human tissue; disease-free survival; middle aged; cancer surgery; survival rate; major clinical study; cancer recurrence; cancer adjuvant therapy; follow up; follow-up studies; cancer grading; neoplasm recurrence, local; clinical protocol; sarcoma; survival time; soft tissue sarcoma; multivariate analysis; retroperitoneal neoplasms; soft tissue neoplasms; retroperitoneal sarcoma; humans; prognosis; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 15
Issue: 8
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1997-08-01
Start Page: 2832
End Page: 2839
Language: English
PUBMED: 9256126
PROVIDER: scopus
DOI: 10.1200/JCO.1997.15.8.2832
DOI/URL:
Notes: Article -- Export Date: 17 March 2017 -- Source: Scopus
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MSK Authors
  1. Murray F Brennan
    1059 Brennan
  2. Jonathan J Lewis
    109 Lewis
  3. Denis Heng Yan Leung
    114 Leung
  4. Ephraim S Casper
    108 Casper
  5. James M Woodruff
    162 Woodruff
  6. Martin J. Heslin
    30 Heslin
  7. Elliot Newman
    19 Newman