Treatment of retroperitoneal sarcoma in Germany between 2000 and 2022: a retrospective analysis from the German Cancer Registry Group.
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PURPOSE: This study describes the treatment of retroperitoneal sarcoma (RPS) in Germany between 2000 and 2022, comparing it to existing recommendations and guidelines. METHODS: Data from the cancer registries of 13 out of 15 federal states was used. Included cases had a retroperitoneal localization (ICD) and histology (ICD-O) corresponding to soft tissue sarcoma. Descriptive analyses of treatment were conducted, focusing on surgical treatment including the development of local residual status and the number of organs resected. RESULTS: Surgery was the most common treatment for cases without metastases, being performed in 79% of cases with available grading data, while systemic therapy (7.6%) and radiotherapy (6.5%) were used less frequently; treatment information was missing for 17% of cases. The most frequent surgeries involved kidneys, intestines and the adrenal gland. In over a third of the cases (38%), multiple organs were resected, especially in cases of adipocytic tumors, where the rate was 46%. CONCLUSION: German cancer registry data allow to characterize treatment of rare diseases such as RPS by supplying detailed information on tumor site and histology. Data quality of German cancer registries improved over time. Treatment patterns of RPS in Germany appear to follow current recommendations regarding extent of surgery and multimodal treatment. The findings align with existing cohort studies from expert centers and (inter-) national guidelines, emphasizing surgery as the only curative option, with multivisceral resection being the preferred approach, especially for adipocytic tumors. Despite potential limitations due to underreporting, cancer registry data provides valuable insights into the medical care situation of the rare RPS.