Key result
En bloc resection of retroperitoneal sarcoma with major vessel involvement is linked to 43% morbidity.
Why the study?
Due to limited clinical series and lack of registries, the short- and long-term benefits of concomitant major arterio-venous resection in retroperitoneal sarcoma extending to major vessels remain antagonistic.
Observational (n=14)
No
En bloc resection of retroperitoneal sarcomas with involved major blood vessels is feasible and achieves acceptable morbidity and mortality, supporting its use for complete tumor clearance.
Background: Due to the limited number of clinical series and the lack of multi-institutional or national registries concerning retroperitoneal sarcoma (RPS) extending to major arterio-venous structures, the short and long-term benefits following concomitant resection of these major structures are still antagonistic. Objective: To present our institutional experience with RPS tumors, to assess their vascular involvement and to analyze the outcomes of onco-vascular approach. Patients and methods: A retrospective review of our institutional RPS patients’ clinical charts was performed. All consecutive adult patients surgically treated for RPS were included. Resection of RPS tumors was followed by histopathological examination for grading. Types of vascular involvement were assessed preoperatively. RPS tumors were resected en bloc together with blood vessels according to the type of vascular involvement and the surgical standards. Results: This study included 14 patients; 8 males (57%) and 6 females (43%) with RPS. Vascular resection was performed in all patients. Adherent structures were resected in 43%. Resection was performed for 29% RPSs with arterial venous involvement, 14% with only arterial involvement, and 57% with only venous involvement. All RPSs were classified as high-grade lesions, and 64% showed secondarily major vessels involvement. 43% of patients were treated by arterial resection. 80% had venous involvement. Venous resections were followed by venous reconstruction in all patients with both arterial and venous involvement. The morbidity rate was 43% while the mortality rate was 7%. Conclusion: Complete resection with clear margins is important for long-term survival in patients with retroperitoneal soft tissue sarcomas.
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Gad et al. (2019) conducted an observational in Retroperitoneal sarcoma with vascular involvement (n=14). En bloc resection with vascular reconstruction (onco-vascular approach) was evaluated on Morbidity rate. En bloc resection of retroperitoneal sarcoma with major blood vessel involvement resulted in a 43% morbidity rate and a 7% mortality rate.
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