P-268 Surgical outcomes and strict follow-up of retroperitoneal soft-tissue sarcoma

Introduction: Treatment and survival features in a consecutive series of 89 patients affected by primary or recurrent retroperitoneal sarcoma (RPS) were reported. Eighty-three among them underwent resection and all of them were treated and strictly followed-up. Methods: Between July 1994 and December 2015, 89 patients (36M, 53F; mean age 60 years, range 25-79) were evaluated. For the purpose of the analysis, complete resection was defined as removal of gross tumor with histologically confirmed clear resection margins. Results: Among the 83 out of 89 (93%) patients who underwent surgical exploration, 46 were affected by primary RPS and 37 by recurrent RPS. Sixty-one patients received a grossly and microscopically complete surgical resection and 54 (65%) required the removal of contiguous intra-abdominal organs too. Perioperative mortality was 1 out of 83 (a patient judged unresectable, operated because of tumour-related haemoperitonaeum. Significant complications regarded 9 (16%) cases only. Dramatic impact on survival was held by tumor differentiation grade: high grade stood for a worse prognosis, with 2 out of 33 patients surviving (6%) at five years follow up, against 53 out of 55 (96%) surviving patients among those affected by low-grade sarcoma (p = 0,0004). Amongst completely resected patients, in addition to the tumor grade, the other parameter having a serious impact on survival was preoperative blood transfusion: with a 79% 5-years survival for low grade completely resected sarcomas against no-survival for high-grade, 5 years survival among patients who did not needed perioperative blood transfusion was 88%, against 37% only for preoperative transfused patients. Conclusion: An aggressive surgical approach in both primary and recurrent RPS is associated with long—term survival.