Prognostic Factors and Postoperative Complications in Retroperitoneal Sarcoma Resection

We collected the baseline characteristics that might affect the patient's prognosis such as gender, age, tumor burden, and histologic subtypes. Surgery-related indicators such as operative time, intraoperative blood loss, and the number of combined organ resections were also collected. Among them, the physical status of patients before anesthesia was assessed according to the American Society of Anesthesiologists Physical Status (ASA score) [12 (link)]. Tumor burden was the sum of the maximum diameters of all tumors in the patient. According to the 2020 World Health Organization pathological classification, the pathological types were classified as follows: (1) well-differentiated liposarcoma; (2) dedifferentiated liposarcoma; (3) leiomyosarcoma; (4) solitary fibroma; and (5) Others [13 (link)]. Meanwhile, according to the French Federation of Centers for the Fight against Cancer (FNCLCC) criteria, tumors were graded into I, II, and III [13 (link)]. Complete resection was defined as grossly negative margins, including both R0 and R1 resections. In 2017, realizing that the removal of specific organs may mean more complications, the Transatlantic RPS Working Group scored the different organs removed, as follows: Adrenal gland, aortocaval lymph nodes, appendix, gallbladder, inguinal ligament, omentum, psoas fascia, and skin are 0 points; Adnexa and/or uterus, bladder, bone, diaphragm,
distal pancreas, duodenum or duodenojejunal flexure, femoral/sciatic/obturator nerve or lumbar/sacral nerve root, iliac artery and/or aorta, iliac vein and/or IVC, kidney, left colon and/or rectum, liver, lung, parietal muscles, pericardium, posterior vaginal wall, prostate (with or without seminal vesicle), psoas muscle, right colon, small bowl, spleen, stomach, testis and/ or spermatic cord and/or vas deferens, and ureter (complete or partial resection not associated with nephrectomy) is 1 point; pancreaticoduodenectomy is 2 points [7 (link)]. According to the above scoring criteria, we scored each patient's organ resection.
Postoperative complications within 30 days were the primary endpoint of this study, and were classified according to the Clavien–Dindo Classification [14 (link)] as follows: I, abnormal conditions not requiring medical therapy or surgery, endoscopy, and radiation therapy; II, complications requiring medical therapy other than Level I complications; III, complications requiring surgery, endoscopy, or radiation therapy Complications; IV, life-threatening complications; V, postoperative death. Among them, grade III or above was defined as serious postoperative complications.