Locoregional recurrence of retroperitoneal soft tissue sarcoma: second chance of cure for selected patients

Background: Locoregional recurrence of a retroperitoneal soft tissue sarcom a (RSTS) may offer a second chance of curative surgical treatment. In a pop ulation-based study the proportion of patients developing isolated locoregi onal recurrences (LR) was determined and the outcome of these patients was analysed. Method: In a retrospective nationwide study, data were collected on 142 pat ients treated between I January 1989 and I January 1994 for primary RSTS. I n patients who had been treated radically for their primary sarcoma (77/142 , 54%), the pattern of recurrence was evaluated. Factors predictive of surv ival for patients with LR were studied. Results: After a median follow-up of 86 (range 60-101) months, 32 patients (42%) had developed LR, and distant metastasis (DM) had been diagnosed in 1 7 patients (22%). Median disease-free interval between the initial operatio n and the establishment of LR or DM was 22 and 19 months, respectively. Fiv e-year cumulative survival of patients with established LR was 37% in compa rison with 11% for patients with DM (P=0.062). Factors predictive of favour able outcome in patients with LR were the absence of multifocal recurrence (n = 13; P = 0.01), lipomatous histomorphology (n = 20; P = 0.02), and a co mplete resection of recurrent sarcoma (n = 17; P = 0.04). Conclusion: After a median follow-up of 7 years following radical treatment of a primary RSTS, 42% of the patients had developed isolated locoregional recurrences. A complete resection of recurrent disease, lipomatous histomo rphology and the absence of multifocal growth influenced prognosis favourab ly. (C) 2001 Harcourt Publishers Ltd.