Martin Marie Bertrand1, Sébastien Carrère1, Laure Delmond1, Sanket Mehta2, Philippe Rouanet1, Ludovic Canaud3, Pierre Alric4, François Quénet5. 1. Surgical Oncology Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France. 2. Surgical Oncology Department, Saifee Hospital, Mumbai, Maharashtra, India. 3. Department of Vascular and Thoracic Surgery, Hôpital Arnaud de Villeneuve, Montpellier, France. 4. Surgical Oncology Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France; Surgical Oncology Department, Saifee Hospital, Mumbai, Maharashtra, India. 5. Surgical Oncology Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France. Electronic address: francois.quenet@icm.unicancer.fr.
Abstract
OBJECTIVE: This study analyzed the outcomes of a series of consecutive patients diagnosed with a retroperitoneal soft tissue sarcoma (RSTS) with vascular involvement and who underwent a multidisciplinary operation. METHODS: Between 2000 and 2013, 126 patients were referred for oncovascular surgery in our institution. Among these, 31 consecutive patients underwent operations for RSTS with vascular involvement. A vascular/oncologic team determined the surgical strategy preoperatively. RESULTS: Median follow-up was 34.4 months (interquartile range, 48.1 months). Twenty patients (65%) were referred for primary RSTS and 11 (35%) for local recurrence. The most common histologic diagnosis was liposarcoma (54.8%), mainly high-grade and intermediate-grade RSTS. Prosthetic grafts were usually used for vascular reconstruction. Median hospital stay was 17 days (interquartile range, 14.5; range, 7-190 days). The grade 3 and 4 morbidity rate was 19.3%. Each resection was macroscopically complete (R0-R1). Median progression-free survival was 10 months, and median overall survival was not reached. Overall survival rates were 77.4% at 1 year and 61.3% at 3 years. CONCLUSIONS: Vascular resection and reconstruction are safe and feasible in case of RSTS. The morbidity rate was acceptable, and there were no perioperative deaths. Despite recurrence rates that remain high, oncovascular resection enhances resection margins and allows encouraging survival results for patients often considered as nonresectable.
OBJECTIVE: This study analyzed the outcomes of a series of consecutive patients diagnosed with a retroperitoneal soft tissue sarcoma (RSTS) with vascular involvement and who underwent a multidisciplinary operation. METHODS: Between 2000 and 2013, 126 patients were referred for oncovascular surgery in our institution. Among these, 31 consecutive patients underwent operations for RSTS with vascular involvement. A vascular/oncologic team determined the surgical strategy preoperatively. RESULTS: Median follow-up was 34.4 months (interquartile range, 48.1 months). Twenty patients (65%) were referred for primary RSTS and 11 (35%) for local recurrence. The most common histologic diagnosis was liposarcoma (54.8%), mainly high-grade and intermediate-grade RSTS. Prosthetic grafts were usually used for vascular reconstruction. Median hospital stay was 17 days (interquartile range, 14.5; range, 7-190 days). The grade 3 and 4 morbidity rate was 19.3%. Each resection was macroscopically complete (R0-R1). Median progression-free survival was 10 months, and median overall survival was not reached. Overall survival rates were 77.4% at 1 year and 61.3% at 3 years. CONCLUSIONS: Vascular resection and reconstruction are safe and feasible in case of RSTS. The morbidity rate was acceptable, and there were no perioperative deaths. Despite recurrence rates that remain high, oncovascular resection enhances resection margins and allows encouraging survival results for patients often considered as nonresectable.
Authors: Alex B Blair; Bradley N Reames; Jasvinder Singh; Faiz Gani; Heidi N Overton; Robert J Beaulieu; Ying W Lum; James H Black; Fabian M Johnston; Nita Ahuja Journal: J Surg Oncol Date: 2018-06-07 Impact factor: 3.454
Authors: S Hulova; R Aziri; I Vulev; P Palacka; G Kolnikova; K Rejlekova; M Chovanec; J Mardiak; D Pindak; M Mego Journal: BMC Surg Date: 2020-11-07 Impact factor: 2.102