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Salvage Surgery for Recurrent Retroperitoneal Well-Differentiated Liposarcoma: Early Reoperation may not Provide Benefit

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Current evidence regarding salvage resection for recurrent retroperitoneal (RP) sarcomas generally lacks detailed histology-specific analyses, but the aggressiveness of these tumors varies widely by histology. We investigated associations between timing and extent of salvage surgery and survival outcomes in patients with recurrent RP well-differentiated liposarcoma (WDLPS).

Methods

The University of Texas MD Anderson Cancer Center Surgical Oncology sarcoma database was reviewed to identify patients with RP WDLPS who underwent surgical resection for first recurrent disease (salvage surgery) in 1995–2015. Medical records were retrospectively reviewed to identify factors associated with overall survival and disease-free survival.

Results

We identified 52 patients who underwent salvage surgery for RP WDLPS for first local recurrence; 28 (54%) underwent salvage surgery within 6 months after recurrence. Concomitant organ resections were performed in 32 (62%) patients, 4 (13%) of whom had pathologic invasion of resected organs. After R0/R1 resections (n = 45), 38 (84%) experienced a second local recurrence. Multivariable analyses revealed that organ invasion at the primary surgery [hazard ratio (HR) 13.08; p = 0.005] and disease-free interval < 1 year (HR 3.64; p = 0.044) were associated with shorter overall survival. Recurrence-to-salvage interval < 6 months was associated with shorter disease-free survival (HR 2.18; p = 0.025). Concomitant organ resection was associated with a longer hospital stay: ≥ 14 days (odds ratio 21.58; p = 0.007).

Conclusions

Early salvage surgery may not always be the best approach for recurrent RP WDLPS patients. Because organ invasion is rare among recurrent RP WDLPS patients and concomitant organ resection is associated with a longer hospital stay, preservation of uninvolved organs should be considered.

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Acknowledgment

Supported in part by the National Institutes of Health/National Cancer Institute under award number P30CA016672 (used the Clinical Trials Support Resource). The authors thank Sunita Patterson, Department of Scientific Publications, The University of Texas MD Anderson Cancer Center, for editorial assistance.

Conflict of interest

The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Naruhiko Ikoma MD, MS, Christina L. Roland MD, Keila E. Torres MD, PhD, Yi-Ju Chiang MSPH, Gary N. Mann MD, Kelly K. Hunt MD, Janice N. Cormier MD, MPH & Barry W. Feig MD

  2. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Wei-Lien Wang MD

  3. Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Neeta Somaiah MD

Authors
  1. Naruhiko Ikoma MD, MS
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  2. Christina L. Roland MD
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  3. Keila E. Torres MD, PhD
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  4. Yi-Ju Chiang MSPH
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  5. Wei-Lien Wang MD
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  6. Neeta Somaiah MD
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  7. Gary N. Mann MD
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  8. Kelly K. Hunt MD
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  9. Janice N. Cormier MD, MPH
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  10. Barry W. Feig MD
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Corresponding author

Correspondence to Barry W. Feig MD.

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Ikoma, N., Roland, C.L., Torres, K.E. et al. Salvage Surgery for Recurrent Retroperitoneal Well-Differentiated Liposarcoma: Early Reoperation may not Provide Benefit. Ann Surg Oncol 25, 2193–2200 (2018). https://doi.org/10.1245/s10434-018-6417-6

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  • DOI: https://doi.org/10.1245/s10434-018-6417-6

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