Retroperitoneal Liposarcoma: Treatment Outcome in Primary and Secondary Surgical Intervention

Background: Approximately 30% to 40% of all retroperitoneal soft tissue tumors are sarcomas, with liposarcoma prevailing in approximately 50% of these cases. Retroperito-neal liposarcomas typically show a high rate of local recurrence and late distant metastases. The aim of our retrospective analysis was to investigate the efficacy of treatment in our patients with liposarcoma.Methods: Thirty-four consecutive patients underwent surgery in our clinic between October 2004 and November 2017. Liposarcomas arising from the mesenteric or abdominal adipose tissue or the pelvis were excluded.Results: Of 34 patients, 23 (67.6%) presented with primary and 11 (32.4%) with recurrent disease. In 7 of the 34 patients (20.6%), a radical resection (R0) could be achieved, and in 27 patients (76.5%) resection was marginal (R1). Time to recurrence was not affected by neoadjuvant radiotherapy. Patients who underwent systemic chemotherapy followed by radiotherapy developed earlier recurrences (P 1/4 0.003) than patients with neoadjuvant radiotherapy only. Overall survival was significantly better in the neoadjuvant group (P 0.045)Conclusions: Combining surgical resection with neoadjuvant radiation treatment showed survival benefits in primary but not recurrent disease. Repeated surgery remains a valid approach in carefully selected patients, but all patients should be referred to a center of expertise in multimodal treatment approaches for retroperitoneal liposarcomas.