Effect of nephrectomy for retroperitoneal sarcoma on post‐operative renal function

Kim, Daniel B.; Gray, Richard; Li, Zhuo; Wasif, Nabil; Bagaria, Sanjay P.

doi:10.1002/jso.24875

Cited by 15 publications

(7 citation statements)

References 27 publications

(34 reference statements)

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“…This may have a potentially beneficial effect, at least with respect to short‐term morbidity and mortality. In contrast, studies have shown moderate, but significant, effects on long‐term morbidity and quality of life from extended resection/MVR, including decrements in renal function, neuropathy, and chronic pain …”

Section: Discussionmentioning

confidence: 95%

“…Although prior publications have detailed acceptable short and long term morbidity and mortality rates following extended resection for RPS, there are limited analyses examining RPS surgical outcomes in large cohorts using national datasets. A prior American College of Surgeons National Surgical Quality Improvement Program (ACS‐NSQIP) analysis investigated 30‐day mortality and morbidity rates following MVR for RPS .…”

Section: Introductionmentioning

confidence: 99%

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Morbidity, mortality and temporal trends in the surgical management of retroperitoneal sarcoma: An ACS‐NSQIP follow up analysis

Judge

Lata-Arias

Yanagisawa

et al. 2019

Journal of Surgical Oncology

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Background: Calls for multivisceral resection (MVR) of retroperitoneal sarcoma (RPS) are increasing, although the risks and benefits remain controversial. We sought to analyze current 30-day morbidity and mortality rates, and trends in utilization of MVR in a national database.Methods: Overall morbidity, severe morbidity, mortality rates, and temporal trends were analyzed utilizing the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP).Results: From 2012 to 2015, a total of 564 patients underwent RPS resection with 233 patients (41%) undergoing MVR. The MVR group had a higher rate of preoperative weight loss and larger tumors overall. When comparing MVR to non-MVR, there was no significant difference in overall morbidity (22% vs 17%, P = .13), severe morbidity (11% vs 8%, P = .18), or mortality (<1% vs 2%, P = .25). On multivariate analysis, MVR was not associated with increased overall morbidity or severe morbidity. Mortality rates were too low for meaningful statistical analysis.Annual rates of MVR ranged from 37% to 46% with no significant change over time (P = .47).Results: Short-term morbidity and mortality rates after MVR for RPS remain acceptable, but rates of MVR show little change over time in NSQIP hospitals.Concerns about increased morbidity and mortality should not be viewed as a contraindication to wider implementation of MVR for RPS.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Morbidity, mortality and temporal trends in the surgical management of retroperitoneal sarcoma: An ACS‐NSQIP follow up analysis

Judge

Lata-Arias

Yanagisawa

et al. 2019

Journal of Surgical Oncology

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“…Complete resection remains one of the important predictors of outcome, which is best achieved by resecting the tumor en bloc with possibly involved contiguous organs, blood vessels, and other structures, even if exploration reveals negligible infiltration (13,14). In most cases of RPS, resecting the adjacent organs (e.g., kidney and colon) can be relatively safe and without severe complications (15). However, pancreatic resection often correlates with significant morbidity and mortality (16).…”

Section: Discussionmentioning

confidence: 99%

“…In most cases of RPS, resecting the adjacent organs (e.g., kidney and colon) can be relatively safe and without severe complications ( 15 ). However, pancreatic resection often correlates with significant morbidity and mortality ( 16 ).…”

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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“…Importantly, of the three patients in the study The data reported in this study are consistent with previous reports from single-institution retrospective studies. Approximately 50% of patients will develop new CKD stage C 3 following nephrectomy based on reports from the Royal Marsden Hospital (n = 113), 3 Mayo Clinic Florida (n = 47), 4 and Massachusetts General Hospital (n = 54). 5 Only two patients out of the 214 combined patients (0.93%) from these studies required postoperative dialysis.…”

mentioning

confidence: 99%

Nephrectomy for Retroperitoneal Sarcoma: Stay Calm and (Cautiously) Carry On

Fairweather

Raut

2020

Ann Surg Oncol

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Effect of nephrectomy for retroperitoneal sarcoma on post‐operative renal function

Abstract: Nephrectomy as part of an en-bloc resection is associated with a decrease in GFR that is not clinically significant. Fear of kidney failure should not prevent a surgeon from performing a nephrectomy in the treatment of RPS.

Cited by 15 publications

References 27 publications

Morbidity, mortality and temporal trends in the surgical management of retroperitoneal sarcoma: An ACS‐NSQIP follow up analysis

Morbidity, mortality and temporal trends in the surgical management of retroperitoneal sarcoma: An ACS‐NSQIP follow up analysis

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

Nephrectomy for Retroperitoneal Sarcoma: Stay Calm and (Cautiously) Carry On

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