Surgically resected retroperitoneal sarcoma: a high-volume center outcome

Background Local recurrence is the main cause of treatment failure in retroperitoneal sarcoma (RPS). Surgical gross tumor resection with negative margins in a high-volume hospital is the hope for cure. We aimed to evaluate the surgical and oncological outcomes of RPS in our high-volume cancer center. Patients and methods This retrospective study included all patients who underwent surgical resection of RPS who presented to the National Cancer Institute, Cairo University, Egypt, from January 2010 to December 2019, and follow-up until December 2021. Results he study included 109 patients who underwent surgical resection. The most common histological type was liposarcoma in 74 (67.9%) patients. Eighty-four (77%) patients received macroscopic gross resection (R0/R1). Contiguous organ resection when invaded was done in 51 (46.8%) patients. The 60-day mortality rate was 9.2% (10 patients). The 60-day morbidity rate was 26.6% (29 patients). The lethal complications were the secondary hemorrhage (three, 10.3%) and intestinal leakage (five, 17.2%). The cumulative overall survival of the whole cohort was 70.5, 58.6, and 57.4% at 3, 5, and 10 years, respectively. The independent prognostic factors were the type of resection and the tumor grade. The cumulative disease-free survival of the whole cohort was 53, 47, and 44% at 3, 5, and 10 years, respectively. The independent prognostic factor was the type of resection. Conclusions Primary surgical resection of RPS should be aggressive with excision of frankly invaded nearby organs. Obtaining R0 resection is the hope for cure. Debulking surgery is considered in the setting of palliation. Serving RPS patients in high-volume centers is the key to a better outcome and life quality.