11
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Extended resection including adjacent organs and Ki-67 labeling index are prognostic factors in patients with retroperitoneal soft tissue sarcomas

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Because retroperitoneal soft tissue sarcomas (RPS) are extremely rare, there is a significant lack of clinicopathologic information to optimize the treatment strategy. The aim of this study was to evaluate the prognostic factors in RPS, with particular focus on the Ki-67 labeling index (LI).

          Methods

          We included the data from a total of 23 patients who received treatment for primary RPS at a single center. The variables analyzed in this study included tumor size, histological type, malignancy grade, necrosis, mitosis, and Ki-67 LI. Kaplan-Meier and Cox proportional regression analyses of overall survival (OS) were performed to identify significant prognostic variables.

          Results

          Of the 23 patients who underwent surgical resection, 9 (39 %) underwent simple resection of the tumor and 14 (61 %) extended resection including the adjacent organs. In the univariate analysis, a simple tumor resection and a high Ki-67 LI were associated with shorter OS. The multivariate analysis revealed that simple tumor resection and a high Ki-67 LI were independent negative prognostic factors for OS.

          Conclusions

          Our results suggested that combined resection of RPS and its adjacent organs improved OS. Pathologically, a high Ki-67 LI was significantly associated with negative prognosis.

          Related collections

          Most cited references22

          • Record: found
          • Abstract: found
          • Article: not found

          Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control.

          To define the optimal initial management and the best extent of surgery that would optimize margins on primary retroperitoneal sarcomas (RPS). A total of 382 patients with primary RPS were analyzed. Sixty-five patients had a simple resection of the tumor, 120 patients had a complete compartmental resection (systematic resection of noninvolved contiguous organs), 130 patients had a contiguously involved organ resection, 21 patients had a systematic re-excision, 38 patients had an incomplete gross resection, and eight patients had a biopsy alone. Radiotherapy and chemotherapy were administered to 121 and 145 patients, respectively. One, 3-, and 5-year overall survival (OS) rates were 86% (95% CI, 0.82 to 0.89), 66% (95% CI, 0.61 to 0.71), and 57% (95% CI, 0.51 to 0.62), respectively. Median overall survival was 6 years. In the multivariate analysis, high grade, tumor rupture, gross residual disease, and positive margins were associated with decreased OS. Low grade, no tumor rupture, negative histologic margins, a high number of patients undergoing operation per center, and compartmental resection compared with standard procedures were associated with decreased abdominal recurrences. Compartmental resection is a significant variable, predicting a 3.29-fold lower rate of abdominal recurrence compared with simple complete resection. Complete compartmental surgery without tumor rupture should be performed when possible to achieve clear margins. This surgery should be performed in a high-volume center. The role of adjuvant treatments should be evaluated in a randomized trial in association with this optimal surgery.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Prognostic factors in retroperitoneal sarcoma: a multivariate analysis of a series of 165 patients of the French Cancer Center Federation Sarcoma Group.

            Surgery is the main prognostic factor in retroperitoneal sarcoma. However, despite progress, surgery alone is rarely curative, and analysis of the causes of failures and of other prognostic factors are warranted to ascertain treatment orientations. Data of patients treated from 1.80 to 12.94 for primary retroperitoneal sarcoma were extracted from the French Federation of Cancer Centers Sarcoma Group registry. Univariate and multivariate analysis were performed for initial local control and for local and general outcome. One hundred sixty-five patients (median age, 54 years; range, 16--82 years) were identified. Median tumor size was 15 cm (range, 2--70 cm); 31% of tumors presented with neurovascular or bone involvement. Liposarcoma, leiomyosarcoma, and malignant fibrous histiocytoma represented 66% of the tumors. Eighty-four percent of the tumors were of high or intermediate grade. Twenty patients had initial metastases. Multimodality treatment included surgery (150 patients), radiotherapy (92 patients), and chemotherapy (77 patients). Complete excision was achieved in 94 of 145 nonmetastatic patients. Median follow-up was 47 months (range, 3--160 months). Actuarial overall 5-year survival rate (median) was 46% (51 months). The main prognostic factors for survival were initial metastases and surgery, which represented the major treatment-linked factor. High-grade of tumors affected local recurrence, metastatic recurrence, and survival. Adjuvant radiotherapy was significantly associated with reduced local recurrence. Various evolutive patterns were observed with histologic subtypes. Aggressive surgery remains mandatory in retroperitoneal sarcoma, but a randomized trial is needed to evaluate the place of radiotherapy for local control. Copyright 2001 American Cancer Society.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Outcomes for soft-tissue sarcoma in 8249 cases from a large state cancer registry.

              To date, outcome reports for soft-tissue sarcoma (STS) have largely been limited to single or paired institutional series. To more accurately elucidate population-based outcomes and prognostic factors associated with STS, a large cancer registry was examined. STS arising in the Florida Cancer Data System were examined (1981-2004). A total of 8249 patients were identified, the calculated annual incidence of sarcoma being approximately 38 cases per million in 2003. The tumor histologies among these patients were leiomyosarcoma and gastrointestinal stromal tumor (LMS/GIST) (43.5%), malignant fibrous histiocytoma (MFH) (31.5%), liposarcoma (19.0%), and fibrosarcoma (6.0%). Tumors were situated in the extremities (30.7%), truncal or visceral locations (50.4%), retroperitoneum (11.7%), and head or neck (7.2%). Thirty-three percent of lesions were over 10 cm in greatest dimension, while 50.2% were classified as high grade. Median overall survival was 25 months. Superior survival was observed for liposarcomas and fibrosarcomas as compared to MFH and LMS/GIST (P < 0.001). Retroperitoneal and truncal sarcomas had a more ominous prognosis than did other sites (P < 0.001). Multivariate analysis of pretreatment variables demonstrated that increasing age, male gender, non-Caucasian race, advanced stage, and a truncal or retroperitoneal location were each independently associated with lower survival. Histological subtype was also an independent predictor of outcome. Surgical resection and radiation therapy were the only treatment variables shown to improve survival. Histological subtype, tumor site, and stage are independent prognostic factors in STS. Surgical resection and radiotherapy are unique among treatment modalities in association with a significant survival benefit.
                Bookmark

                Author and article information

                Contributors
                tigers.yosuke@gmail.com
                makitomiyake@yahoo.co.jp
                keijishi@naramed-u.ac.jp
                horimaus@gmail.com
                takuro.birds.nest@gmail.com
                unnkoderu@hotmail.com
                sanai@naramed-u.ac.jp
                sendo@nmu-gw.naramed-u.ac.jp
                nkonishi@naramed-u.ac.jp
                +81-744-22-3051 , kiyokun@naramed-u.ac.jp
                Journal
                World J Surg Oncol
                World J Surg Oncol
                World Journal of Surgical Oncology
                BioMed Central (London )
                1477-7819
                24 February 2016
                24 February 2016
                2016
                : 14
                : 43
                Affiliations
                [ ]Department of Urology, Nara Medical University, 840 Shijo-cho, Nara, 634-8522 Japan
                [ ]Department of Pathology, Nara Medical University, Nara, Japan
                Article
                810
                10.1186/s12957-016-0810-z
                4765233
                26911364
                c8e35517-49f4-4610-9d87-8e8ec8f125f5
                © Morizawa et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 July 2015
                : 17 February 2016
                Funding
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100005782, Nara Medical University (JP);
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100005782, Nara Medical University (JP);
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100005782, Nara Medical University (JP);
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100005782, Nara Medical University (JP);
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100005782, Nara Medical University (JP);
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100005782, Nara Medical University (JP);
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100005782, Nara Medical University (JP);
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100005782, Nara Medical University (JP);
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100005782, Nara Medical University (JP);
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100005782, Nara Medical University (JP);
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Surgery
                extended resection,ki-67,prognostic factor,retroperitoneal,soft tissue sarcoma
                Surgery
                extended resection, ki-67, prognostic factor, retroperitoneal, soft tissue sarcoma

                Comments

                Comment on this article