Histologic Type Predicts Survival in Patients with Retroperitoneal Soft Tissue Sarcoma1

Tseng, Warren; Martinez, Steve R.; Tamurian, Robert M.; Borys, Dariusz; Canter, Robert J.

doi:10.1016/j.jss.2010.07.056

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Volume 172, Issue 1 , Pages 123-130, January 2012

Histologic Type Predicts Survival in Patients with Retroperitoneal Soft Tissue Sarcoma¹

Warren Tseng, M.D.
- Department of Surgery, Division of Surgical Oncology, University of California, Davis Medical Center, Sacramento, Califronia
Steve R. Martinez, M.D., M.A.S.
- Department of Surgery, Division of Surgical Oncology, University of California, Davis Medical Center, Sacramento, Califronia
Robert M. Tamurian, M.D.
- Department of Orthopedic Surgery, Division of Orthopedic Oncology, University of California, Davis Medical Center, Sacramento, Califronia
Dariusz Borys, M.D.
- Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, Califronia
Robert J. Canter, M.D.
- Department of Surgery, Division of Surgical Oncology, University of California, Davis Medical Center, Sacramento, Califronia
- To whom correspondence and reprint requests should be addressed at Department of Orthopedic Surgery, Division of Orthopedic Oncology, University of California, Davis Medical Center, Suite 3010, 4501 X Street, Sacramento, CA 95817.

Received 10 June 2010; accepted 28 July 2010. published online 01 September 2010.

Background

Histologic grade, completeness of resection, and presence of metastases are traditionally regarded as the primary factors in predicting survival for retroperitoneal soft tissue sarcoma (RPSTS). We sought to examine the importance of histologic type as a prognostic factor among patients with RPSTS.

Methods

We identified 2337 cases of RPSTS in the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2004. After excluding 273 cases of age <18, identification by autopsy only, or absence of histologic confirmation, we arrived at a final study cohort of 2064 patients. Overall survival (OS) and disease-specific survival (DSS) were estimated using the Kaplan-Meier method. Multivariate analysis was performed using a Cox proportional hazards model, adjusting for age, gender, race, histologic type, histologic grade, tumor size, extent of resection, and SEER summary stage.

Results

Among 33 histologic types, leiomyosarcoma (28.7%), well-differentiated/dedifferentiated liposarcoma (20.3%), liposarcoma not otherwise specified (NOS) (11.9%), malignant fibrous histiocytoma (MFH–11.0%), and sarcoma NOS (10.7%) were the most prevalent. Grade distribution was low, 24.2%; intermediate, 16%; high 34.3%, and unknown, 25.5%. Surgery was performed in 85.8%, and radiotherapy was administered to 22.8%. With a median follow-up of 38 mo, median OS was 78, 35, 25, 18, and 10 mo for liposarcoma, leiomyosarcoma, other histologies, MFH, and sarcoma NOS, respectively (P < 0.0001). Median DSS was 120, 53, not reached, 30, and 13 mo for liposarcoma, leiomyosarcoma, other histologies, MFH, and sarcoma NOS, respectively (P < 0.0001). On multivariate analysis, histologic type was associated with statistically significant differences in both OS and DSS.