Surgical outcome and patterns of recurrence for retroperitoneal sarcoma at a single centre

Hogg, Jeffry; Manas, DM; Lee, D; Dildey, Petra; Scott, Julius; Lunec, John; French, J.

doi:10.1308/rcsann.2016.0057

Cited by 10 publications

(7 citation statements)

References 14 publications

(23 reference statements)

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“…This remains technically difficult because of deep-seated location, multifocality, and necessity of multi-visceral resections [4]. The principal cause of failure is locally recurrent disease, [5] with debate concerning the value of adjuvant chemotherapy and/or radiotherapy [6]. Risk stratification is based upon the American Joint Committee on Cancer (AJCC) staging for soft tissue sarcomas (STS) of the extremity, where the main factors implicated in survival include the histologic tumor grade, the pathologic subtype, and the resection margins [7].…”

Section: Introductionmentioning

confidence: 99%

Aggressive Surgical Approach for Treatment of Primary and Recurrent Retroperitoneal Soft Tissue Sarcoma

et al. 2018

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To analyze treatment and survival in a series of resected patients with primary or recurrent retroperitoneal sarcoma (RPS) treated and prospectively followed at a single institution. Between July 1994 and December 2015, 89 patients (36 M, 53 F; mean age 60 years, range 25-79) were evaluated. For the purpose of analysis, complete resection was defined as removal of gross tumor with histologically confirmed clear resection margins. Eighty-three out of the 89 patients (93%), 46 of whom affected by primary RPS, and 37 by recurrent RPS, underwent surgical exploration. Sixty-two had a grossly and microscopically complete resection. Fifty-three out of 83 patients (64%) underwent removal of contiguous intra-abdominal organs. Preoperative mortality was nil and significant preoperative complications occurred in six cases only (7%). High-grade tumor pointed out to be a significant variable for a worse survival in all 83 patients amenable to undergo surgical resection (57% 5 years survival for low grade vs 14% for high grade; = 0.0004). Among completely resected patients, only histologic grade clearly affected disease-free survival (72% 5 years survival for low grade vs 50% for high grade; = 0.04), while the role of preoperative blood transfusions (67% 5 years survival for non-transfused patients vs 29% for transfused patients; = 0.05) has to be evaluated in connection to patient complexity. Histological grade and recurrence are the most valuable prognostic predictors; in this clinical subset, an aggressive surgical approach in both primary and recurrent RPS is associated with a best long-term survival and disease-free survival.

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Section: Introductionmentioning

confidence: 99%

Aggressive Surgical Approach for Treatment of Primary and Recurrent Retroperitoneal Soft Tissue Sarcoma

et al. 2018

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“…The other study, Hogg et. al, it was noti ed in 88.9% (80, total 90) [11]. Our nding that all patients had a macroscopically clear margin is thus superior to conventional studies.…”

Section: Discussionmentioning

confidence: 60%

Intra- and Extra- Pelvic Multidisciplinary Surgical Approach of Retroperitoneal Sarcoma: Case Series Report

Song¹,

Ahn²,

Jung³

et al. 2021

Preprint

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Objective: We aim to describe our experience of multidisciplinary surgical resection of retroperitoneal sarcoma (RPS), including intra- and extrapelvic approaches.Method: Multidisciplinary surgery is an anatomical approach combining intra- and extraperitoneal access within the same surgery to achieve complete RPS removal. This retrospective review of the records of patients who underwent multidisciplinary surgery for RPS analyzed surgical and survival outcomes.Result: Eight patients underwent 10 intra- and extrapelvic surgical resection and their median mass size was 12.75 cm (range, 6–45.5 cm). Using an intrapelvic approach, laparoscopy-assisted surgery was performed in 4 cases and laparotomy surgery in 6 cases. Using an extrapelvic approach, ilioinguinal and posterior approaches were used in 4 cases each, prone position and midline skin incision were shared in 1 case. All patients’ RPS masses were removed completely and 4 patients achieved R0 resection through intra- and extrapelvic surgery. Additionally, pelvic lymph node dissections or prophylactic fixation or revision of structures were conducted. The median estimated blood loss was 2000 mL (range, 300–20 000 mL) and the median hospitalization was 12.6 days (range, 9–69 days). Reoperation was needed in 2 patients (one for wound necrosis, the other for bowel perforation and wound necrosis). The median overall survival rate and median progression-free survival were 64.6 months and 13.7 months, respectively.Conclusion: RPS are therapeutically challenging based on their locations and high risk of recurrence. Considering that, intra- and extrapelvic surgical approach could improve the macroscopic security of the surgical margin.

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“…The Memorial Sloan Kettering Cancer Center reported that majority of patients with RPS died of advanced local tumor recurrence in the absence of systemic diseases (9). A lot of effort to improve the OS of RPS was focused on local control through adjuvant radiotherapy or surgical techniques (10). Although adjuvant radiotherapy tended to be beneficial to improve OS (11), surgery remains the mainstay of curative therapy for RPS (12).…”

Section: Discussionmentioning

confidence: 99%

Pancreaticoduodenectomy for Retroperitoneal Sarcomas: A Mono-Institutional Experience in China

Wang

Liu

et al. 2020

Front. Oncol.

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Background: En bloc resection of retroperitoneal sarcoma (RPS) with adjacent organs such as pancreatic head and duodenum is challenging for surgeons. This monoinstitutional study aims to evaluate the feasibility, safety, and outcome of performing pancreaticoduodenectomy (PD) during RPS resection. Methods: The clinical data of RPS patients who underwent PD at the Sarcoma Center of Peking University Cancer Hospital from January 2011 to December 2019 was collected and analyzed. Results: Twenty-seven patients out of a total of 264 surgically treated RPS underwent PD. The main pathological subtype was liposarcoma. All patients received concomitant resection of a median of three additional organs (range: 1-5), including 11 patients (40.7%) who underwent inferior vena cava resection and one patient who underwent segmental superior mesenteric-portal vein resection. Microscopic tumor infiltration to the duodenum or pancreas was observed in 81.5% of patients. Major complications occurred in 40.7% of patients; the reoperation rate was 22.2%. One patient (3.7%) died from liver abscess postoperatively. During a median follow-up of 18.9 months, 15 patients (55.6%) developed locally recurrent disease; two patients (7.4%) also had pulmonary metastases additionally. Twelve patients (44.4%) died from local relapse eventually. Conclusion: PD during RPS resection is feasible, and it may be necessary to achieve complete resection. However, considering the complexity and risk, it should be performed by an experienced surgical team. The long-term survival benefit of this procedure should be verified by further large-scale multi-institutional studies.

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Surgical outcome and patterns of recurrence for retroperitoneal sarcoma at a single centre

Cited by 10 publications

References 14 publications

Aggressive Surgical Approach for Treatment of Primary and Recurrent Retroperitoneal Soft Tissue Sarcoma

Aggressive Surgical Approach for Treatment of Primary and Recurrent Retroperitoneal Soft Tissue Sarcoma

Intra- and Extra- Pelvic Multidisciplinary Surgical Approach of Retroperitoneal Sarcoma: Case Series Report

Pancreaticoduodenectomy for Retroperitoneal Sarcomas: A Mono-Institutional Experience in China

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