Postoperative Morbidity After Resection of Recurrent Retroperitoneal Sarcoma: A Report from the Transatlantic Australasian RPS Working Group (TARPSWG)

Carolyn Nessim*, Chandrajit P. Raut, Dario Callegaro, Francesco Barretta, Rosalba Miceli, Mark Fairweather, Piotr Rutkowski, Jean Yves Blay, Dirk Strauss, Ricardo Gonzalez, Nita Ahuja, Giovanni Grignani, Vittorio Quagliuolo, Eberhard Stoeckle, Antonino De Paoli, Venu G. Pillarisetty, Carol J. Swallow, Sanjay P. Bagaria, Robert J. Canter, John T. MullenYvonne Schrage, Elisabetta Pennacchioli, Winan van Houdt, Kenneth Cardona, Marco Fiore, Alessandro Gronchi, Guy Lahat

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: This study aimed to evaluate perioperative morbidity after surgery for first locally recurrent (LR1) retroperitoneal sarcoma (RPS). Data concerning the safety of resecting recurrent RPS are lacking. Methods: Data were collected on all patients undergoing resection of RPS-LR1 at 22 Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) centers from 2002 to 2011. Uni- and multivariable logistic models were fitted to study the association between major (Clavien-Dindo grade ≥ 3) complications and patient/surgery characteristics as well as outcome. The resected organ score, a method of standardizing the number of organs resected, as previously described by the TARPSWG, was used. Results: The 681 patients in this study had a median age of 59 years, and 51.8% were female. The most common histologic subtype was de-differentiated liposarcoma (43%), the median resected organ score was 1, and 83.3% of the patients achieved an R0 or R1 resection. Major complications occurred for 16% of the patients, and the 90-day mortality rate was 0.4%. In the multivariable analysis, a transfusion requirement was found to be a significant predictor of major complications (p < 0.001) and worse overall survival (OS) (p = 0.010). However, having a major complication was not associated with a worse OS or a higher incidence of local recurrence or distant metastasis. Conclusions: A surgical approach to recurrent RPS is relatively safe and comparable with primary RPS in terms of complications and postoperative mortality when performed at specialized sarcoma centers. Because alternative effective therapies still are lacking, when indicated, resection of a recurrent RPS is a reasonable option. Every effort should be made to minimize the need for blood transfusions.

Original languageEnglish
Pages (from-to)2705-2714
Number of pages10
JournalAnnals of Surgical Oncology
Issue number5
StatePublished - May 2021
Externally publishedYes


FundersFunder number
Merck Canada


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