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Back to 2014 Annual Meeting Abstracts
Primary Retroperitoneal Sarcomas: Rate of Microscopic Organ Invasion and Prognosis
Mark Fairweather, MD1, Jiping Wang, MD, PhD1,4, Vickie Y Jo, MD2,4, Elizabeth H. Baldini, MD, MPH3,4, Monica M. Bertagnolli, MD1,4, Chandrajit P. Raut, MD, MSc1,4
1Department of Surgery, Division of Surgical Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA; 2Department of Pathology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, 3Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, MA, 4Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Boston MA
BACKGROUND:
The incidence and prognostic implication of microscopic organ invasion (MOI) in primary retroperitoneal sarcomas (RPS) has not been consistently discussed.
METHODS:
Patients (pts) with primary RPS who underwent surgery at our institution were reviewed. Operative and pathology reports were reviewed to identify the number of organs resected, presence of MOI and rationale for organ resection.
RESULTS:
Between January 2002 and December 2011, 120 pts underwent resection of a primary RPS. Of the 175 total organs resected in 55 pts with at least one organ resected with MOI, rationale for resection was frank invasion (N=43, 24.6%), involvement of vascular supply (19, 10.9%), organ encasement (18, 10.3%), tumor adherence (82, 46.9%), required for R0/R1 resection (6, 3.4%), or other (7, 4.0%). For pts with DDLPS, WDLPS, and LMS, MOI was associated with a higher 2-year distant recurrence crude cumulative incidence (CCI) (42.7 v. 15.3%, p=0.02) but no difference in 2-year locoregional recurrence CCI (48.0% v. 42.0%, p=0.59). With a median follow-up of 33.6 months, 5-year overall survival (OS) was significantly worse in pts with MOI (32.6% v. 59.5%, p=0.03; median 38.2 mo v. 99.0 mo).
CONCLUSIONS:
Organ invasion may be predicted by histologic subtype of primary RPS. For the first time, MOI has been shown to be associated with a higher incidence of distant recurrence and worse OS. These data may help guide the minimal extent of surgical resection.
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