A Ten Year Review Of Management And Outcomes Of Retroperitoneal Sarcoma: A Retrospective Cohort Study.

Background: Retroperitoneal sarcomas (RPS) are a heterogeneous group of rare tumours that require complex surgical management with outcomes tightly correlated to quality of surgery.This study aimed to examine the determine patient demographics, treatment approaches and outcomes for patients with primary RPS in this single center during the period 2010-2021.

Methods: All patients diagnosed with RPS from 2010 to 2021 that underwent surgical resection in a single trust in Northern Ireland were identified. Data was collated using histopathology records, electronic care records and retrospective chart review.

Results: Fifty-four resections were performed for RPS in a 10 year period. 30 day mortality rate was 3.7%, in-hospital mortality was 1.9% and 90 day mortality was 7.4%. 11.1% of patients were recorded as having a severe postoperative adverse event. 90.4% patients achieved an R0/R1 resection. The 1, 3, and 5-year overall survival were 80% [95% confidence interval (CI) 67-89), 69% (95% CI 53-79), and 62% (95% CI 48-75). The 1 and 5-year crude-cumulative-incidence (CCI) for local recurrence were 32% (95%CI 20, 46) and 55% (95%CI 32,77). 1 and 5-year CCI for distant metastases were 11% (95%CI 4, 23) and 35% (95%CI 15,59). Median overall survival was 6.3 years (IQR 5.0-7.6).

Conclusion: Survival outcomes in this LVH are similar to those reported by a number of HVHs worldwide, with an additional low rate of severe postoperative complication. Given that there are only between 250 and 300 new diagnoses of retroperitoneal sarcoma (RPS) in the UK each year prospective data collection and participation in multi-institution studies, specifically a UK collaboration, is critical to expand upon current knowledge and further improve management, outcomes and follow-up of patients with this rare and complex surgical disease.