Management of retroperitoneal sarcoma involving the iliac artery: Single-center surgical experience

Abstract

BACKGROUND Management of retroperitoneal sarcoma (RPS) involving the iliac artery is challenging and requires the concerted efforts of multidisciplinary team (MDT) members during surgical treatment. AIM To summarize the clinicopathologic features of RPS involving the iliac artery and our retroperitoneal soft tissue tumor MDT surgical experience. METHODS In this retrospective study, 15 patients with RPS involving the iliac artery who underwent surgery at our retroperitoneal soft tissue tumor center from July 2004 to June 2020 were analyzed. Statistical analyses were performed by Student’s t -test with SPSS 16.0. RESULTS Complete tumor resection (R0/R1) and iliac artery reconstruction were achieved in all 15 patients. All the operations were successful, with no serious complications or perioperative death. Resection with bilateral iliac artery reconstruction required a higher intraoperative blood transfusion volume than resection with unilateral iliac artery reconstruction. Recurrent cases were more likely to bleed and required a higher blood transfusion volume than primary cases. As of January 2021, 11 patients were alive, and 4 had died. Local recurrence occurred in two patients, one of whom developed liver metastasis. CONCLUSION Resection of RPS involving iliac vessels is feasible and effective when performed by MDT members. Iliac artery oncovascular resection and reconstruction are key to a successful operation. Adequate blood preparation is important for successful completion of surgery.

Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review

“…Characteristics of the included studies are shown in Table 1 . From the 23 studies included, there were 4 cohort studies and 19 observational studies describing 699 patients [ 10 , 16 – 37 ]. The PRISMA flow diagram, showing the entire review process from the original search to the final selection of studies, is presented in Fig.…”

Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review

“…Nine studies reported 30-day or in-hospital mortality for RPSs undergoing vascular resection to be 0-8% (overall mortality rate 3%) [10,21,23,25,30,[32][33][34]37]. Nine of the 11 studies reported major complications [10,21,23,25,30,[32][33][34]37], ranging from 7-54% (overall major complication rate 27%). Seven studies (215 patients) reported clinical outcomes of RFS rates of 18-86% [10,21,23,30,[32][33][34]37].…”

“…Nine of the 11 studies reported major complications [10,21,23,25,30,[32][33][34]37], ranging from 7-54% (overall major complication rate 27%). Seven studies (215 patients) reported clinical outcomes of RFS rates of 18-86% [10,21,23,30,[32][33][34]37]. There were 4 studies (237 patients) that reported 5-year OS rates that varied between 50% and 73% [10,32,33,37].…”

“…The inferior vena cava (IVC) was the most involved major vessel. In total, 12 studies [16- 20, 22, 24, 26-28, 35, 36] (359 participants) reported data on primary iliocaval leiomyosarcoma, 11 studies [10,21,23,25,[29][30][31][32][33][34]37] (340 participants) reported data on other RPSs undergoing vascular resection, and 4 studies [10,29,31,32] (959 participants) compared the long-term outcomes between aggressive surgical approach with vascular resection and tumour resection alone in patients with RPS. Characteristics of the included 4 studies are shown in Table 2.…”

“…Seven studies (215 patients) reported clinical outcomes of RFS rates of 18-86% [10,21,23,30,[32][33][34]37]. There were 4 studies (237 patients) that reported 5-year OS rates that varied between 50% and 73% [10,32,33,37].…”