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ORIGINAL RESEARCH article

Front. Oncol.

Sec. Surgical Oncology

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1575260

Multiple Surgical Interventions Improve Survival in Locally Recurrent Retroperitoneal Sarcoma: A Retrospective Cohort Analysis

Provisionally accepted
Guojun  YanGuojun YanXinbao  LiXinbao LiKai  ZhangKai ZhangChao  GaoChao GaoLijun  YanLijun YanXinjing  ZhangXinjing ZhangSonglin  AnSonglin AnYanbin  ZhangYanbin Zhang*
  • Beijing Shijitan Hospital, Capital Medical University, Beijing, China

The final, formatted version of the article will be published soon.

Background: Locally recurrent retroperitoneal sarcoma (RPS) poses substantial clinical challenges, especially in patients experiencing multiple recurrences. This study aims to evaluate the survival benefits conferred by repeated surgical resections in the management of recurrent RPS.Methods: A retrospective cohort study was conducted involving 56 patients who underwent repeated surgical resections for locally recurrent RPS at our institution between June 2016 and September 2023. Demographic, clinical, and histopathological variables-including age, sex, tumor differentiation, FNCLCC grade, prior radiotherapy and chemotherapy, surgical margin status, and postoperative complications-were collected and analyzed. Survival outcomes were assessed using Kaplan-Meier estimates and Cox proportional hazards models.The median age of the cohort was 53 years (range: 28-72), with a male-tofemale ratio of 30:26. Compared to a single resection, median overall survival (OS) improved with successive surgeries: 79.3 months for two surgeries, 158.0 months for three, and 181.7 months for four. However, OS declined to 121.9 months following five resections. Tumor differentiation and FNCLCC grade were significantly associated with survival outcomes. Multivariate analysis identified age, pathological subtype, tumor grade, and number of surgeries as independent prognostic factors. Although severe adverse events (SAEs) were recorded, no 30-day postoperative mortality occurred.Conclusions: Repeated surgical resection appears to confer substantial survival benefits in patients with locally recurrent RPS, underscoring the clinical value of surgical management in selected cases. These findings highlight the importance of individualized surgical strategies, while emphasizing the need for further investigation to optimize treatment paradigms.

Keywords: Retroperitoneal sarcoma, Surgical interventions, Survival outcomes, Oncological prognosis, recurrent disease

Received: 12 Feb 2025; Accepted: 11 Jul 2025.

Copyright: © 2025 Yan, Li, Zhang, Gao, Yan, Zhang, An and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Yanbin Zhang, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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