Outcomes after resection of leiomyosarcomas of the inferior vena cava: A pooled data analysis of 377 cases

Wachtel, Heather; Gupta, Meera; Bartlett, Edmund K.; Jackson, Benjamin M.; Kelz, Rachel R.; Karakousis, Giorgos C.; Fraker, Douglas L.; Roses, Robert E.

doi:10.1016/j.suronc.2014.10.007

Cited by 98 publications

(127 citation statements)

References 17 publications

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“…The 5‐year OS and 10‐year OS were 49.4% and 29.5%, respectively, for patients who received radical resection, whereas the mean survival was only 3 months for untreated patients. In 2015, Wachtel et al published a pooled data analysis of 377 cases of LMS that underwent resection . They reported a 5‐year OS of 55%, which is comparable to that reported by Mingoli .…”

Section: Prognosismentioning

confidence: 79%

“…They reported a 5‐year OS of 55%, which is comparable to that reported by Mingoli . Older age, larger tumor size, resection of adjacent organs and surgical margin status were identified as the independent predictors of a lower OS . Otherwise, it has already been suggested that tumors of the middle segment of the IVC have a better prognosis than those of the upper segment.…”

Section: Prognosismentioning

confidence: 91%

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Major vascular resections in retroperitoneal sarcoma

Tzanis

Bouhadiba

Gaignard

et al. 2017

Journal of Surgical Oncology

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Retroperitoneal sarcomas (RPS) frequently involve major vessels, which either originate from them or secondarily encase or invade them. In this field, major vascular resections result in increased morbidity. However, survival does not seem to be affected by the need for vascular resection or by this higher morbidity. This paper aims to provide descriptions of the surgical strategy and outcomes for retroperitoneal sarcomas involving major vessels.

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Section: Prognosismentioning

confidence: 79%

Section: Prognosismentioning

confidence: 91%

Major vascular resections in retroperitoneal sarcoma

Tzanis

Bouhadiba

Gaignard

et al. 2017

Journal of Surgical Oncology

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“…All of which were present in our patient. The IVC graft-related morbidity include graft thrombosis, sepsis and the risk of pulmonary embolism 10. Local recurrences occur in 13%–33% of patients, whereas distant metastases are seen in 30%–50% of patients 10.…”

Section: Discussionmentioning

confidence: 99%

“…The IVC graft-related morbidity include graft thrombosis, sepsis and the risk of pulmonary embolism 10. Local recurrences occur in 13%–33% of patients, whereas distant metastases are seen in 30%–50% of patients 10. Liver transplantation for primary or secondary liver sarcomas have been fraught with unacceptable rates of recurrence and remain a poor choice of treatment 11.…”

Section: Discussionmentioning

confidence: 99%

“…According to a pooled analysis of 377 cases, the overall survival rate after curative surgical resection at 1 year and 5 years were 92% and 57%, and the disease-free survival at 1 year and 5 years were 55% and 5%, respectively 10. BCS is seen in up to 25% of patients either due to direct tumour infiltration or thrombosis of hepatic veins, and outcomes are particularly poor due to the associated liver dysfunction 5 10 12.…”

Section: Discussionmentioning

confidence: 99%

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Liver transplantation for inferior vena cava leiomyosarcoma: from a Maslow’s hammer to the Occam’s razor

Gunasekaran

Rammohan²,

Reddy

et al. 2018

BMJ Case Reports

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Leiomyosarcoma (LMS) of primary vascular origin is a rare entity with only potentially curative option being complete surgical resection; despite which the prognosis remains dismal. Tumour recurrence is very common, and the benefits of adjuvant therapy are undefined. A 39-year-old woman presented with 6 months’ history of abdominal pain, abdominal distension and pedal oedema. On evaluation, she was diagnosed to have chronic Budd-Chiari syndrome (BCS) secondary to a tumour arising from the inferior vena cava (IVC) on evaluation. Her liver decompensation included jaundice, gastrointestinal bleed and ascites. Following a detailed multidisciplinary team discussion, she underwent complete excision of the tumour along with a segment of the IVC with living donor liver transplantation. She remains disease-free 24 months following surgery. This is the first reported case of liver transplantation for IVC LMS causing chronic BCS.

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Surgical and oncologic approach to leiomyosarcoma of the inferior vena cava: A case report

Maniso,

Woldegeorgis,

Bedada

2024

Clinical Case Reports

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Key Clinical MessageLMS of IVC needs a multidisciplinary approach. Surgical excision with free margin is the cornerstone of management. Upon case‐by‐case selection, adjuvant chemotherapy may play a role in better oncologic outcome.AbstractLeiomyosarcoma (LMS) of the inferior vena cava (IVC) is a rare form of mesenchymal origin malignancy with less than 400 cases reported to date. Surgery is the mainstay of management but it requires vast experience in vascular and visceral surgery to attain a free tumor margin. Subsequent adjuvant treatment with chemotherapy and radiation remains as an area of gray zone. We report the case of a 61‐year‐old man with an 8‐month history of abdominal pain. Upon physical examination, an ill‐defined mass over the right side of the lower abdomen and bilateral lower extremity edema were detected. Abdominal ultrasound with Doppler revealed a right‐side retroperitoneal mass invading the IVC with extensive venous thrombosis for which anticoagulation was initiated. Computed Tomography of the abdomen revealed a huge heterogeneously enhancing mass involving the whole length of the infrarenal IVC obstructing the IVC lumen with collateral veins draining through the paralumbar veins and inferior epigastric veins bilaterally. With a top differential of primary IVC LMS, a midline longitudinal laparotomy was performed with an intraoperative finding of a tumor arising from the infra‐renal IVC which was excised. Gore‐Tex graft was used to reconstruct the IVC. There was an injury to the right common iliac artery and it was repaired by end‐to‐end anastomosis. Histopathology confirmed a high‐grade LMS of the IVC and surgical margin status was unknown. He was given adjuvant Chemotherapy consisting of Doxorubicin and Dacarbazine. He has been on follow‐up at the Oncology side with a good performance status.

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Outcomes after resection of leiomyosarcomas of the inferior vena cava: A pooled data analysis of 377 cases

Cited by 98 publications

References 17 publications

Major vascular resections in retroperitoneal sarcoma

Major vascular resections in retroperitoneal sarcoma

Liver transplantation for inferior vena cava leiomyosarcoma: from a Maslow’s hammer to the Occam’s razor

Surgical and oncologic approach to leiomyosarcoma of the inferior vena cava: A case report

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