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Pooling over a thousand patients from eight expert centres showed that recurrence after retroperitoneal sarcoma surgery depends on histology: liposarcoma recurs locally, leiomyosarcoma spreads distantly, which shapes follow-up and the case for radiotherapy or chemotherapy by subtype.
Retrospective analysis of 1,007 patients with primary retroperitoneal sarcoma treated with curative-intent surgery at eight Trans-Atlantic Retroperitoneal Sarcoma Working Group centres, describing patterns of local and distant recurrence and survival by histology.
Five-year overall survival was 67 percent; well-differentiated liposarcoma recurred locally with almost no metastases, dedifferentiated liposarcoma recurred both ways, and leiomyosarcoma had a high distant recurrence rate with low local recurrence.
Histology-specific strategies, such as considering neoadjuvant chemotherapy for leiomyosarcoma and high-grade dedifferentiated liposarcoma in STRASS2, follow from these patterns.