Introduction

Surgical treatment of re­troperitoneal sarcomas often involves extensive multi-organ resection in order to achieve radical resection and, consequently, improve oncological outcomes. Such operations carry significant risks, including a rate of postoperative complications of up to around 20%, of which 5% are fatal. To ensure maximum patient safety and effectively manage complications, these operations should be performed in specialised referral centres with extensive experience in this type of procedure. Retroperitoneal sarcomas account for approximately 20% of all soft tissue sarcomas. Currently, surgical treatment involves multi-organ resection of the tumour along with adjacent organs, which is a major surgical challenge. In our study, we present an analysis of the frequency of organ-specific resection, complications, and hospital length of stay.

Material and methods

We included 177 patients who underwent surgical treatment for retroperitoneal sarcoma at the National Institute of Cancer between 2016 and 2023. Each patient underwent multi-organ resection if oncologically necessary.

Results

R0 resections were performed in 47 patients, R1 in 120, and R2 in 10. The average tumour size for resection was: R0 margin: 19 cm (range: 2–45 cm), R1 margin: 26 cm (range: 4–57 cm), and R2 margin: 26 cm (range: 9–47 cm). The median length of hospitalisation was 8 days, and the time was significantly longer for extensive procedures (p < 0.001). Of the 177 patients who underwent surgery, 39 (22%) required reoperation. Death due to postoperative complications occurred in 7 patients (4%).

Conclusions

Treating retroperitoneal sarcomas involves highly complex surgeries associated with complication rates of up to 20% and a mortality rate of approximately 5%. However, extensive multi-organ resection is justified because it maximises the likelihood of achieving surgical radicality, which yields the most favourable oncological outcomes. Due to these inherent risks, such operations must be strictly performed in specialised, high-volume referral centres capable of optimal surgical planning and complication management.