TITLE:
Analysis of the Onco-Vascular Approach in Retroperitoneal Sarcoma with Vascular Involvement
AUTHORS:
Zeiad Gad, Ahmed Gamal, Karim Sallam
KEYWORDS:
Outcomes, Retroperitoneal Sarcoma, Vascular Approach
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.10 No.8,
August
7,
2019
ABSTRACT: 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.