Nathan et al identified factors affecting the survival after resection of a primary retroperitoneal sarcoma. These can help to identify a patient who may benefit from a more aggressive management. The authors are from the Johns Hopkins University and Brigham and Women's Hospital.
Patient selection: primary retroperitoneal sarcoma
Outcome: overall survival
Factors associated with worse survival:
(1) unfavorable histologic subtype
(2) histologic grade 3 or 4
(3) tumor invasion of adjacent structures
(4) older age (odds ratio 1.33 per decade)
(5) male gender
(6) distant metastases (M1) and increasing Stage
Factors associated with better survival:
(1) favorable histologic subtype
(2) grade 1
(3) no invasion of adjacent structures
(4) younger age
(5) female gender
(6) no distant metastases
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Favorable Histology (Odds Ratio < 1)
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Intermediate (Odds Ratio 1 to 1.5)
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Unfavorable Histology (Odds Ratio > 2)
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malignant mesenchymoma
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liposarcoma
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rhabdomyosarcoma
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hemangiopericytoma
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leiomyosarcoma
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MPNST
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malignant fibrous histiocytoma
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hemangiosarcoma
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fibrosarcoma
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sarcoma NOS
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Factors not predictive of survival:
(1) diameter of the tumor
(2) the presence of lymph node metastases
The fact that the subjects underwent tumor resection may have excluded some patients with distant metastases considered unresectable.
