P62: Risk Factors for the Development of Early Recurrence in Patients with Primary Retroperitoneal Sarcoma

Friday, March 24, 2023

12:36 PM – 12:41 PM

Location: SSO HUB: Melanoma & Sarcoma Zone

Poster Presenter(s)

Fabio Tirotta, MD

Consultant Surgical Oncologist
University Hospital Birmingham NHS Foundation Trust, United Kingdom

Disclosure information not submitted.

Author(s)

Fabio Tirotta, MD

Consultant Surgical Oncologist
University Hospital Birmingham NHS Foundation Trust, United Kingdom

Disclosure information not submitted.
MF

Michael Fadel, n/a

Research Fellow
The Royal Marsden Hospital NHS Foundation Trust, United States

Disclosure information not submitted.
MB

Marco Baia, n/a

Surgical Oncologist
University Hospitals Birmingham NHS Foundation Trust, United States

Disclosure information not submitted.
AP

Alessandro Parente, n/a

Surgical Oncologist
University Hospital Birmingham NHS Foundation Trust, United States

Disclosure information not submitted.
VM

Valentina Messina, n/a

Surgical Oncologist
University Hospitals Birmingham NHS Foundation Trust, United States

Disclosure information not submitted.
PB

Paul Bassett, n/a

Statistician
Statsconsultancy, United States

Disclosure information not submitted.
MS

Myles J. Smith, FRCS

Consultant
The Royal Marsden NHS Foundation trust, United States

Disclosure information not submitted.
MA

Max Almond, n/a

Surgical Oncologist
University Hospital Birmingham NHS Foundation Trust, United States

Disclosure information not submitted.
Andrew J. Hayes, MBBS FRCS PhD

Consultant Surgical Oncologist
Royal Marsden Hospital
London, United Kingdom

Disclosure information not submitted.
AD

Anant Desai, n/a

Surgical Oncologist
University Hospital Birmingham NHS Foundation Trust, United States

Disclosure information not submitted.
SF

Sam Ford, n/a

Surgical Oncologist
University Hospital Birmingham NHS Foundation Trust, United States

Disclosure information not submitted.
DS

Dirk Strauss, n/a

Surgical Oncologist
The Royal Marsden Hospital NHS Foundation Trust, United States

Disclosure information not submitted.

Introduction: Surgery is the only potentially curative treatment for patients with retroperitoneal sarcoma (RPS). However, recurrence rates are high and surgery may have little benefit for patients who recur early. Our study examined the incidence of early recurrence (ER) in RPS patients and the association between ER and prognosis, aiming to identify the factors associated with their development.

Methods: Data on patients undergoing surgery for primary RPS from 2008 to 2019 were extracted from an institutional dataset at two tertiary RPS centres. ER were defined as any evidence of local recurrence and/or distant metastases at the CT-scan up to 6 months from surgery. Overall survival (OS) was calculated using the Kaplan-Meier method. Deaths due to postoperative complications or R2 resections, and patients with less than 6 months follow-up, were excluded from the analysis. A multivariable analysis was calculated to identify independent predictors of ER.

Results: Of the 692 patients who underwent surgery during the study period, 657 were included in the analysis, 65 of whom (9.9% [95% confidence interval: 7.7% to 12.4%]) developed ER. Five-year OS was 3% in patients with ER compared to 76% in patients without ER (p < 0.001). Patients’ characteristics were compared between ER and non-ER, and ECOG performance status (p=0.008), tumor histology (p=0.002), tumor grading (p < 0.001), radiotherapy (p=0.04) and postoperative complications measured as comprehensive complications index (p=0.003) were found to be significantly associated with ER. However, the only significant independent predictors of ER on multivariable analysis were ECOG performance status of 2-3 (versus ECOG 0), grade 3 on histology (versus 1), and left-sided RPS (versus right-sided), with an odds ratio (OR) of 3.10 (1.15-8.39), p< 0.005; 14.8 (4.44-49.2), p< 0.001; and 0.53 (0.29, 0.98, p< 0.07), respectively.

Conclusions: ER are associated with poor prognosis. High tumor grading and increased ECOG performance status are independent predictors for the development of ER. These patients may benefit the most from novel neo-adjuvant therapeutic options.

Learning Objectives:

To understand the incidence and the prognostic impact of early recurrence in patients with primary retroperitoneal sarcoma.
To identify which factors are independently associated with the development early recurrence in patients with primary retroperitoneal sarcoma.
To potentially consider patients at high risk for the development of early recurrence for new therapeutic options.