Impact of histology on survival in retroperitoneal sarcomas.

BACKGROUND: The current American Joint Committee on Cancer AJCC staging system applies to all soft-tissue sarcomas and does not allow for consideration of many features unique to retroperitoneal sarcomas (RPSs). The aim of this study was to analyze factors predictive of recurrence and survival for patients with resected RPSs. METHODS: This was a retrospective analysis of consecutive patients with primary RPS who underwent resection. A 3-tiered histological classification was examined: atypical lipomatous tumors (ALTs), non-ALT liposarcomas (LPSs), and other. Univariate and multivariate analyses were used to identify factors associated with differences in disease-free survival (DFS) and overall survival (OS) among groups. RESULTS: Sixty RPS patients were analyzed: 16 patients (27%) had ALTs, 7 patients (12%) had LPSs, and 37 patients (62%) had other histologies. A comparison of the 3 groups showed a significant difference in OS among groups (P < .017). High-grade tumors favored shorter DFS (P = .06) but were not associated with decreased OS when compared with low-grade tumors (P = .86). CONCLUSIONS: These findings support an alternative staging system for RPS, inclusive of histology, which may prove useful in operative planning and prognostication.

Anal incontinence-sphincter ani repair: indications, techniques, outcome.

INTRODUCTION: Fecal incontinence is a debilitating problem that has many different causes. There also are many treatments options, from behavioral modification to sphincteroplasty to artificial anal sphincter and colostomy. In a society with an aging population, fecal incontinence is an ever-increasing problem and will continue to grow. DISCUSSION: Treatment plans need to be individually tailored for each patient. The surgeon should be proficient in different types of procedures and match the procedure with the needs of the patient. Long-term follow-up of these patients must continue to help us better serve this patient population.