Morbidity, mortality and temporal trends in the surgical management of retroperitoneal sarcoma: An ACS‐NSQIP follow up analysis

Judge, Sean J; Lata-Arias, Kathleen; Yanagisawa, Mio; Darrow, Morgan A.; Monjazeb, Arta M.; Kirane, Amanda; Bold, Richard J.; Canter, Robert J.; Canter, Daniel

doi:10.1002/jso.25649

Cited by 16 publications

(13 citation statements)

References 28 publications

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“…Currently available literature on the long‐term survival rate of upper extremity sarcoma reports ranges that vary widely, 54–56 with high correlations noted between mortality and histological subtype, oncologic stage, radicality of surgical treatment, and the use of (neo)adjuvant radio‐ and chemotherapy 27,57,58 . The 30‐day mortality rate in our cohort was 0.65%, which is reasonable when compared to general hand surgery (0.3%) or the resection of retroperitoneal sarcoma (<2%) 59,60 …”

Section: Discussionmentioning

confidence: 59%

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Factors associated with 30‐day soft tissue complications following upper extremity sarcoma surgery

Hoftiezer

Lans

Freniere

et al. 2020

Journal of Surgical Oncology

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Background and ObjectivesThe incidence of soft tissue complications following sarcoma surgery in the upper extremity is reportedly high. Therefore, this study assessed the National Surgical Quality Improvement Program (NSQIP) database to identify independent risk factors, while also reporting the incidence of soft tissue complications in the first 30 days after surgery.MethodsA total of 620 patients that underwent surgical treatment for upper extremity sarcoma were included from the NSQIP database. Soft tissue complications were defined as surgical site infection, wound dehiscence, or soft‐tissue related reoperations. Clinically relevant patient and treatment characteristics were selected and analyzed.ResultsThe 30‐day soft tissue complication rate was 4.7%. In the multivariable analysis, higher body mass index (p = .047) and longer operative times (p = .002) were independently associated with soft tissue complications.ConclusionsHigher body mass index and longer operative times are risk factors for soft tissue complications following upper extremity sarcoma surgery. The soft‐tissue complication rate following resection of upper extremity tumors is low in this national cohort, possibly due to the relatively small tumor size and low prevalence of radiotherapy.

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Section: Discussionmentioning

confidence: 59%

“…27,57,58 The 30-day mortality rate in our cohort was 0.65%, which is reasonable when compared to general hand surgery (0.3%) or the resection of retroperitoneal sarcoma (<2%). 59,60 5 | CONCLUSIONS…”

Section: Discussionmentioning

confidence: 99%

Factors associated with 30‐day soft tissue complications following upper extremity sarcoma surgery

Hoftiezer

Lans

Freniere

et al. 2020

Journal of Surgical Oncology

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“…Furthermore, a recent 2019 retrospective study by Judge et al used data from the American College of Surgeons National Surgical Quality Improvement Program and sought to address 30‐day morbidity and mortality rates associated with multivisceral resection for RPS. In their study of 564 patients, when comparing multivisceral resections with nonmultivisceral resections, there was no significant difference noted in overall morbidity (22% vs 17%; P = .13), severe morbidity (11% vs 8%; P = .18), or mortality (<1% vs 2%; P = .25) 126 . Therefore, extended operations with multiorgan en bloc resections and/or vascular reconstructions should be considered for all RPS with the goal of achieving a macroscopically complete resection, with a single specimen encompassing the tumor and involved contiguous organs, while minimizing microscopically positive margins.…”

Section: Retroperitoneal Stsmentioning

confidence: 95%

Soft‐tissue sarcoma in adults: An update on the current state of histiotype‐specific management in an era of personalized medicine

Gamboa

Gronchi

Cardona

2020

CA A Cancer J Clinicians

383

340

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Soft-tissue sarcomas (STS) are rare tumors that account for 1% of all adult malignancies, with over 100 different histologic subtypes occurring predominately in the trunk, extremity, and retroperitoneum. This low incidence is further complicated by their variable presentation, behavior, and long-term outcomes, which emphasize the importance of centralized care in specialized centers with a multidisciplinary team approach. In the last decade, there has been an effort to improve the quality of care for patients with STS based on anatomic site and histology, and multiple ongoing clinical trials are focusing on tailoring therapy to histologic subtype. This report summarizes the latest evidence guiding the histiotype-specific management of extremity/truncal and retroperitoneal STS with regard to surgery, radiation, and chemotherapy.

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“…In resection with a high risk for complications, pancreatectomy was carried out in 2%, and partial liver resection in 1%. 77 In another study by the Multi-institutional Collaborative RPS Working Group of 1007 RPS patients who underwent combined resection of a median of two organs, the colon was resected in 57.2%, kidneys in 54.2%, psoas muscle (partial/total) in 27.1%, spleen in 16.0%, and iliac vein and/or inferior vena cava in 10.9%. Combined resection with high-risk organs involved the distal pancreas in 11.2%, liver in 2.3%, duodenum/head of the pancreas in 0.9% and duodenum or duodenojejunal junction in 0.3%.…”

Section: Surgical Resectionmentioning

confidence: 99%

“…The most common organs were the intestines in 19%, kidneys in 15% and the blood vessels in 3%. In resection with a high risk for complications, pancreatectomy was carried out in 2%, and partial liver resection in 1% 77 . In another study by the Multi‐institutional Collaborative RPS Working Group of 1007 RPS patients who underwent combined resection of a median of two organs, the colon was resected in 57.2%, kidneys in 54.2%, psoas muscle (partial/total) in 27.1%, spleen in 16.0%, and iliac vein and/or inferior vena cava in 10.9%.…”

Section: Malignant Rptsmentioning

confidence: 99%

Retroperitoneal tumors: Review of diagnosis and management

Sassa

2020

Int J of Urology

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Retroperitoneal tumors are extremely rare tumors occurring in the retroperitoneum. Retroperitoneal tumors are divided into benign tumors and malignant tumors, including retroperitoneal sarcoma. Approximately 70-80% of primary retroperitoneal soft-tissue tumors are malignant; however, these only account for 0.1-0.2% of all malignancies. Retroperitoneal sarcoma is an orphan malignant disease with a low incidence. The information on benign retroperitoneal tumors is limited. The American Joint Committee on Cancer/TNM classification updated to the 8th edition in 2017. In 2010, three new drugs for soft tissue sarcoma were approved based on the results of phase III trials, but the histological subtypes of the patients enrolled in the trials of each drug differed. Recently, in addition to surgery for retroperitoneal sarcoma, the effectiveness of perioperative radiation therapy has become interesting. For malignant retroperitoneal tumors and retroperitoneal sarcoma, survival improvement and locoregional recurrence prevention can be undertaken by carrying out surgery to secure negative margins with wide and combined resection of some adjacent organs, and cooperation with a trained medical team comprising of radiologists, pathologists and medical oncologists in centralized hospitals. Some clinical trials aimed at further improving treatment results by adding preoperative chemotherapy and radiation therapy based on histological confirmation using a correct needle biopsy are in progress. In recent years, molecular profiling has been used to select eligible patients for chemotherapy. In the future, precision medicine with next-generation sequencing technology will be expected among the diverse and potential future treatments for retroperitoneal sarcoma. In this review, we summarized the current state of retroperitoneal tumors and retroperitoneal sarcoma.

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Morbidity, mortality and temporal trends in the surgical management of retroperitoneal sarcoma: An ACS‐NSQIP follow up analysis

Cited by 16 publications

References 28 publications

Factors associated with 30‐day soft tissue complications following upper extremity sarcoma surgery

Factors associated with 30‐day soft tissue complications following upper extremity sarcoma surgery

Soft‐tissue sarcoma in adults: An update on the current state of histiotype‐specific management in an era of personalized medicine

Retroperitoneal tumors: Review of diagnosis and management

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