Morbidity and Outcomes After Distal Pancreatectomy for Primary Retroperitoneal Sarcoma: An Analysis by the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group

Bagaria, Sanjay P.; Swallow, Carol J.; Suraweera, Harini; Raut, Chandrajit P.; Fairweather, Mark; Cananzi, Ferdinando Carlo Maria; Quagliuolo, Vittorio; Grignani, Giovanni; Hompes, Daphne; Ford, Samuel J.; Nessim, Carolyn; Apte, Sameer; Skoczylas, Jacek; Rutkowski, Piotr; Bonvalot, Sylvie; Tzanis, Dimitri; Gabriel, Emmanuel; Pennacchioli, Elisabetta; Albertsmeier, Markus; Canter, Robert J.; Pollock, Raphael E.; Grignol, Valerie; Cardona, Kenneth; Gamboa, Adriana C.; Novak, Marko; Stoeckle, Eberhard; Almquist, Martin; Ahuja, Nita; Klemen, Nicholas D.; Houdt, Winan J. van; Gyorki, David E.; Gangi, Alexandra; Rastrelli, Marco; Hage, Jos A. van der; Schrage, Yvonne; Valeri, Sergio; Conti, Lorenzo; Spiegel, Matthew R.; Li, Zhou; Fiore, Marco; Gronchi, Alessandro

doi:10.1245/s10434-021-09739-9

Cited by 15 publications

(21 citation statements)

References 18 publications

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“…In their study, 86% (43/50) of patients underwent DP, and rates of complications and severe complications were 64% (32/50) and 28% (14/50), respectively. Also, POPF occurred in 14% (7/50) of cases, with 12% (6/50) of cases being grade B and 2% (1/50) of cases being grade C. The Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) retrospectively reviewed 280 cases in a multicenter study and reported outcomes after DP for RPS ( 7 ). In their study, rates of complications and severe complications were 62.5% (175/280) and 39.6% (111/280), respectively.…”

Section: Discussionmentioning

confidence: 99%

“…( 8 ) in 34% (17/50), and the French Sarcoma Group ( 24 ) in 15.2% (5/33), respectively. In addition, the TARPSWG analyzed only patients who underwent DP and confirmed microscopic pancreatic invasion in 38.2% (107/280) ( 7 ). Similarly, in our study, microscopic pancreatic invasion was confirmed in 42.4% (14/33) of patients who underwent DP.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, in our study, microscopic pancreatic invasion was confirmed in 42.4% (14/33) of patients who underwent DP. The TARPSWG reported that microscopic pancreatic invasion did not affect either LR or OS, but the R1 pancreatic margin was associated with LR ( 7 ). However, microscopic pancreatic invasion was deemed a risk factor associated with LR when multivariate analysis was performed in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Bagaria et al. also reported that distal pancreatectomy (DP) for primary RPS can achieve complete resection with acceptable morbidity and oncologic outcomes ( 7 ). On the other hand, Flacs et al.…”

Section: Introductionmentioning

confidence: 99%

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Postoperative Outcomes of Distal Pancreatectomy for Retroperitoneal Sarcoma Abutting the Pancreas in the Left Upper Quadrant

Kim

Lee

et al. 2021

Front. Oncol.

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BackgroundEn bloc resection of the tumor with adjacent organs is recommended for localized retroperitoneal sarcoma (RPS). However, resection of the pancreas is controversial because it may cause serious complications, such as pancreatic fistula or bleeding. Thus, we evaluated the outcomes of distal pancreatectomy (DP) in pancreas-abutting RPS of the left upper quadrant (LUQ).MethodsWe retrospectively reviewed all consecutive patients who underwent surgery for RPS between September 2001 and April 2020. We selected 150 patients with all or part of their tumor located in the LUQ on preoperative computed tomography. Eighty-six patients who had tumors abutting the pancreas were finally enrolled in our study.ResultsFifty-three patients (53/86; 61.6%) were included in the non-DP group, and 33 patients (33/86; 38.4%) were included in the DP group. Total postoperative complications and complication rates for those Clavien–Dindo grade 3 or higher were similar between the non-DP group and DP group (p = 0.290 and p = 0.550). In the DP group, grade B pancreatic fistulae occurred in 18.2% (6/33) of patients, but grade C pancreatic fistulae were absent, and microscopic pancreatic invasion was noted in 42.4% (14/33) of patients. During multivariate analysis, microscopic pancreatic invasion was deemed a risk factor for local recurrence (p = 0.029). However, there were no significant differences on preoperative computed tomography findings between the pancreatic invasion and non-invasion groups.ConclusionDP is a reasonable procedure for pancreas-abutting RPS located at the LUQ when both complications and complete resection are considered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Postoperative Outcomes of Distal Pancreatectomy for Retroperitoneal Sarcoma Abutting the Pancreas in the Left Upper Quadrant

Kim

Lee

et al. 2021

Front. Oncol.

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“…Major vascular resection of the inferior vena cava, aorta and its major branches are intermittently required and indicated if reconstruction is possible [ 78 ]. Naturally, such benefit must be weighed against the risks of morbidity of resecting additional structures, such as the duodenum or pancreas necessitating pancreaticoduodenectomy, diaphragm or motor nerves, and kidney, all associated with possible significant morbidity [ 79 , 80 , 81 , 82 ]. Additional areas of concern preclude surgical resection include the superior mesenteric vessels, portal and hepatic vessels, pericardium and mediastinal structures, spinal cord and nephrectomy particularly if the contralateral kidney is non-functional [ 79 , 80 , 81 , 83 , 84 ].…”

Section: Management Of Primary Retroperitoneal Sarcomamentioning

confidence: 99%

Retroperitoneal Sarcoma Care in 2021

Schmitz

Nessim

2022

Cancers

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Soft-tissue sarcomas are biologically heterogenous tumors arising from connective tissues with over 100 subtypes. Although sarcomas account for <1% of all adult malignancies, retroperitoneal sarcomas are a distinct subgroup accounting for <10% of all sarcomatous tumors. There have been considerable advancements in the understanding and treatment of retroperitoneal sarcoma in the last decade, with standard treatment consisting of upfront primary surgical resection. The evidence surrounding the addition of radiation therapy remains controversial. There remains no standard with regards to systemic therapy, including immunotherapy. Adjunctive therapy remains largely dictated by expert consensus and preferences at individual centers or participation in clinical trials. In this 2021 review, we detail the anatomical boundaries of the retroperitoneum, clinical characteristics, contemporary standard of care and well as recent advancements in retroperitoneal sarcoma care. Ongoing international collaborations are encouraged to advance our understanding of this complex disease.

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Traditional risk scores do not properly predict perioperative morbidity and mortality for retroperitoneal sarcoma resection

Angelucci

Strumia

Gronchi

et al. 2022

Journal of Surgical Oncology

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Morbidity and Outcomes After Distal Pancreatectomy for Primary Retroperitoneal Sarcoma: An Analysis by the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group

Cited by 15 publications

References 18 publications

Postoperative Outcomes of Distal Pancreatectomy for Retroperitoneal Sarcoma Abutting the Pancreas in the Left Upper Quadrant

Postoperative Outcomes of Distal Pancreatectomy for Retroperitoneal Sarcoma Abutting the Pancreas in the Left Upper Quadrant

Retroperitoneal Sarcoma Care in 2021

Traditional risk scores do not properly predict perioperative morbidity and mortality for retroperitoneal sarcoma resection

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