P61: Outcomes After Resection of Locally Recurrent Retroperitoneal Sarcoma

Friday, March 24, 2023

12:31 PM – 12:36 PM

Location: SSO HUB: Melanoma & Sarcoma Zone

Poster Presenter(s)

Camilla Gasparoli, MD (she/her/hers)

Research Fellow
Mayo Clinic
Rome, Italy

Disclosure information not submitted.

Author(s)

Camilla Gasparoli, MD (she/her/hers)

Research Fellow
Mayo Clinic
Rome, Italy

Disclosure information not submitted.
Justin W. Maroun, MD, PhD

Resident
Mayo Clinic
Rochester, Minnesota, United States

Disclosure information not submitted.
EeeLN Buckarma, MD (she/her/hers)

Resident Physician
Mayo Clinic Dept Surgery
Rochester, Minnesota, United States

Disclosure information not submitted.
Travis E. Grotz, MD

Assistant Professor
Mayo Clinic
Rochester, Minnesota, United States

Disclosure(s): No financial relationships to disclose
Mark J. Truty, MD, MSc

Practice Chair
Mayo Clinic Rochester
Rochester, Minnesota, United States

Disclosure information not submitted.

Author(s)

CT

Cornelius A. Thiels, DO, MBA

Assistant Professor
Division of Hepatobiliary and Pancreas Surgery, Mayo Clinic, United States

Disclosure information not submitted.

Disclosure(s):

Travis E. Grotz, MD: No financial relationships to disclose

Introduction: Local recurrence remains a common problem after resection of retroperitoneal sarcomas (RPS) and limited data exists on the outcomes of re-resection. We aimed to identify prognostic variables that predict 2^nd recurrence after curative intent re-resection of RPS.

Methods: All retroperitoneal well-differentiated liposarcoma (wdLPS), de-differentiated (dd)LPS (with or without wd), and Leiomyosarcomas (LMS) resected at Mayo Clinic from 1/2000-8/2022 were retrospectively identified (n=359). Patients who underwent surgical resection for a local recurrence following complete resection at the initial surgery were included. Descriptive statistics were utilized and the Kaplan-Meier method and log-rank test were used to assess for 2^nd recurrence free survival and overall survival from re-resection.

Results: One-hundred-seventeen patients underwent re-resection for a recurrent RPS. Median age was 61 years and 42% were female. Median follow-up was 5.7 years. Pathology was 37% wdLPS, 44% ddLPS and 24% LMS. Twenty-three percent of patients presented multifocal lesion and 5% had distant metastasis. Median recurrent tumor size was 9 cm and R2 resection rate was 11%. Neoadjuvant therapy was administered in 46% of patients and adjuvant treatment in 7% of patients. Median overall survival was 9.8 years from index operation and 4.7 yrs from re-resection. Median survival after re-resection was not reached in wdLPS, 3.5 years for ddLPS and 3.7 years for LMS (p=0.002). Median disease-free interval was 3.0 years after re-resection. At last follow-up 59% had re-recurred, with 65% local relapse, 17% distant metastasis and 3% with both. Re-recurrence occurred at median of 4.9 years in wdLPS, 4.3 years in ddLPS and 0.85 years in LMS (p < 0.001, Figure).

Conclusions: Resection of recurrent retroperitoneal sarcomas is associated with acceptable oncologic outcomes. Further subset analysis of the factor associated with early recurrence in the ddLPS and LMS subsets, as well as the potential benefit of neoadjuvant therapies prior to re-resection, may help guide patient-selection.

Learning Objectives:

Upon completion, participant will be able to describe the overall survival and re-recurrence rates of selected patients who underwent resection of recurrent RPS.
Upon completion, participant will have a better understanding of the outcomes of surgery for recurrent RPS.
Upon completion, participant will understand risk factors associated with re-recurrence after resection of highly selected patient who underwent surgery.