PROGNOSTIC FACTORS ASSOCIATED WITH LONG-TERM SURVIVAL FOR RETROPERITONEAL SARCOMA - IMPLICATIONS FOR MANAGEMENT

Purpose: Retroperitoneal soft tissue sarcomas are rare tumors. Studies characterizing long-term follow-up and patterns of recurrence are lim ited. The purpose of this analysis is to identify patterns of recurren ce and prognostic factors associated with long-term survival after res ection of retroperitoneal soft tissue sarcomas. Methods: Between July 1, 1982, and June 30, 1990, 198 adult patients were identified from ou r prospective soft tissue sarcoma database carrying the diagnosis of r etroperitoneal soft tissue sarcoma who were eligible for greater than or equal to 5 years of follow-up. Of these, 48 patients (25%) were doc umented to be alive greater than or equal to 5 years from the time of operation. Statistical analysis was by log-rank or Wilcoxon test for u nivariate analysis. Multivariate analysis was by the Cox model. Result s: The recurrence rate during the follow-up period was approximately 5 % per year from the time of initial operation. Of the patients who wer e disease-free for greater than or equal to 5 years from initial surge ry, 40% recurred by 10 years. Radiation therapy was the only factor si gnificant (P =.02) for a reduction in the risk of local recurrence. Ag e less than or equal to 50 years and high-grade tumors were significan t factors (P =.003 and .009, respectively) for an increased risk of di stant metastasis. incomplete gross resection was the only factor signi ficant for an increased risk of tumor mortality (P =.003).Conclusion: Complete surgical resection at the time of primary presentation is lik ely to afford the best chance for long-term survival. With long-term f ollow-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 c andidates for investigational adjuvant therapy. (C) 1997 by American S ociety of Clinical Oncology.