Mahesh Goel1, Anand Mohan1, Shraddha Patkar2, Kunal Gala3, Nitin Shetty3, Suyash Kulkarni3, Jayesh Dhareshwar4. 1. GI & HPB Service, Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Ernest Borges Marg, Parel, Mumbai, 400 012, India. 2. GI & HPB Service, Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Ernest Borges Marg, Parel, Mumbai, 400 012, India. drshraddhapatkar@gmail.com. 3. Department of Interventional Radiology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India. 4. Department of Vascular Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
Abstract
BACKGROUND: Inferior vena cava (IVC) leiomyosarcomas (LMS) are a rare group of retroperitoneal tumors. R0 surgical resection is the only curative modality of treatment. IVC resection for retroperitoneal sarcoma is a complex surgery with no definitive guidelines for reconstruction. METHODS: Retrospective review of all patients who underwent surgical resection of primary leiomyosarcoma of the IVC requiring resection from 2010 to 2020 at our tertiary care center was performed. RESULTS: Among 24 patients who required IVC resection for LMS, only 7 (29%) required reconstruction of IVC. According to Clavien-Dindo classification, there was one grade 3 or more morbidity and 1 post-operative mortality. Seventeen patients underwent R0 resection whereas 7 patients had R1 resection on final histopathology. At a median follow-up of 25 months (range 8-91 months), the median OS was 40 months with median DFS of 28 months. Two patients presented with local recurrence while 13 patients developed systemic recurrence on follow-up. CONCLUSION: Careful preoperative multidisciplinary planning can make IVC resection without reconstruction feasible with acceptable perioperative morbidity, mortality, and oncological outcomes for IVC LMS.
BACKGROUND: Inferior vena cava (IVC) leiomyosarcomas (LMS) are a rare group of retroperitoneal tumors. R0 surgical resection is the only curative modality of treatment. IVC resection for retroperitoneal sarcoma is a complex surgery with no definitive guidelines for reconstruction. METHODS: Retrospective review of all patients who underwent surgical resection of primary leiomyosarcoma of the IVC requiring resection from 2010 to 2020 at our tertiary care center was performed. RESULTS: Among 24 patients who required IVC resection for LMS, only 7 (29%) required reconstruction of IVC. According to Clavien-Dindo classification, there was one grade 3 or more morbidity and 1 post-operative mortality. Seventeen patients underwent R0 resection whereas 7 patients had R1 resection on final histopathology. At a median follow-up of 25 months (range 8-91 months), the median OS was 40 months with median DFS of 28 months. Two patients presented with local recurrence while 13 patients developed systemic recurrence on follow-up. CONCLUSION: Careful preoperative multidisciplinary planning can make IVC resection without reconstruction feasible with acceptable perioperative morbidity, mortality, and oncological outcomes for IVC LMS.
Authors: Pierre A Clavien; Jeffrey Barkun; Michelle L de Oliveira; Jean Nicolas Vauthey; Daniel Dindo; Richard D Schulick; Eduardo de Santibañes; Juan Pekolj; Ksenija Slankamenac; Claudio Bassi; Rolf Graf; René Vonlanthen; Robert Padbury; John L Cameron; Masatoshi Makuuchi Journal: Ann Surg Date: 2009-08 Impact factor: 12.969
Authors: Sylvie Bonvalot; Alessandro Gronchi; Cécile Le Péchoux; Carol J Swallow; Dirk Strauss; Pierre Meeus; Frits van Coevorden; Stephan Stoldt; Eberhard Stoeckle; Piotr Rutkowski; Marco Rastrelli; Chandrajit P Raut; Daphne Hompes; Antonino De Paoli; Claudia Sangalli; Charles Honoré; Peter Chung; Aisha Miah; Jean Yves Blay; Marco Fiore; Jean-Jacques Stelmes; Angelo P Dei Tos; Elizabeth H Baldini; Saskia Litière; Sandrine Marreaud; Hans Gelderblom; Rick L Haas Journal: Lancet Oncol Date: 2020-09-14 Impact factor: 41.316