Outcomes of palliative-intent surgery in retroperitoneal sarcoma-Results from the US Sarcoma Collaborative

被引:11
作者
Thalji, Sam Z. [1 ]
Tsai, Susan [1 ]
Gamblin, T. Clark [1 ]
Clarke, Callisia [1 ]
Christians, Kathleen [1 ]
Charlson, John [2 ]
Ethun, Cecilia G. [3 ]
Poultsides, George [4 ]
Grignol, Valerie P. [5 ]
Roggin, Kevin K. [6 ]
Votanopoulos, Konstantinos [7 ]
Fields, Ryan C. [8 ]
Abbott, Daniel E. [9 ]
Cardona, Kenneth [3 ]
Mogal, Harveshp [1 ]
机构
[1] Med Coll Wisconsin, Dept Surg, 8700 W Wisconsin Ave, Milwaukee, WI 53226 USA
[2] Med Coll Wisconsin, Dept Med Oncol, Milwaukee, WI 53226 USA
[3] Emory Univ, Winship Canc Inst, Div Surg Oncol, Atlanta, GA 30322 USA
[4] Stanford Univ, Med Ctr, Dept Surg, Palo Alto, CA 94304 USA
[5] Ohio State Univ, Dept Surg, Div Surg Oncol, Columbus, OH 43210 USA
[6] Univ Chicago Med, Dept Surg, Chicago, IL USA
[7] Wake Forest Univ, Dept Surg, Winston Salem, NC 27101 USA
[8] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA
[9] Univ Wisconsin, Dept Surg, Madison, WI USA
关键词
palliation; prognostic; RPS; SOFT-TISSUE SARCOMA; MANAGEMENT; PREDICTORS; RESECTION; SURVIVAL;
D O I
10.1002/jso.25890
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background and Objectives Outcomes of palliative-intent surgery in retroperitoneal sarcomas (RPS) are not well understood. This study aims to define indications for and outcomes after palliative-intent RPS resection. Methods Using a retrospective 8-institution database, patients undergoing resection of primary/recurrent RPS with palliative intent were identified. Logistic regression and Cox-proportional hazards models were constructed to analyze factors associated with postoperative complications and overall survival (OS). Results Of 3088 patients, 70 underwent 87 palliative-intent procedures. Most common indications were pain (26%) and bowel obstruction (21%). Dedifferentiated liposarcoma (n = 17, 24%), leiomyosarcoma (n = 13, 19%) were predominant subtypes. Median OS was 10.69 months (IQR, 3.91-23.23). R2 resection (OR, 8.60; CI, 1.42-52.15; P = .019), larger tumors (OR, 10.87; CI, 1.44-82.11; P = .021) and low preoperative albumin (OR, 0.14; CI, 0.04-0.57; P = .006) were associated with postoperative complications. Postoperative complications (HR, 1.95; CI, 1.02-3.71; P = .043) and high-grade histology (HR, 6.56; CI, 1.72-25.05; P = .006) rather than resection status were associated with reduced OS. However, in R2-resected patients, development of postoperative complications significantly reduced survival (P = .042). Conclusions Postoperative complications and high-grade histology rather than resection status impacts survival in palliative-intent RPS resections. Given the higher incidence of postoperative complications which may diminish survival, palliative-intent R2 resection should be offered only after cautious consideration.
引用
收藏
页码:1140 / 1147
页数:8
相关论文
共 18 条
[11]   Analysis of outcomes and predictors of long-term survival following resection for retroperitoneal sarcoma [J].
Malinka, Thomas ;
Nebrig, Maxim ;
Klein, Fritz ;
Pratschke, Johann ;
Bahra, Marcus ;
Andreou, Andreas .
BMC SURGERY, 2019, 19 (1)
[12]   Indications and use of palliative surgery-results of society of surgical oncology survey [J].
McCahill, LE ;
Krouse, R ;
Chu, D ;
Juarez, G ;
Uman, GC ;
Ferrell, B ;
Wagman, LD .
ANNALS OF SURGICAL ONCOLOGY, 2002, 9 (01) :104-112
[13]   Predictors of Survival After Resection of Retroperitoneal Sarcoma A Population-Based Analysis and Critical Appraisal of the AJCC Staging System [J].
Nathan, Hari ;
Raut, Chandrajit P. ;
Thornton, Katherine ;
Herman, Joseph M. ;
Ahuja, Nita ;
Schulick, Richard D. ;
Choti, Michael A. ;
Pawlik, Timothy M. .
ANNALS OF SURGERY, 2009, 250 (06) :970-976
[14]   Surgical management of primary and recurrent retroperitoneal liposarcoma [J].
Neuhaus, SJ ;
Barry, P ;
Clark, MA ;
Hayes, AJ ;
Fisher, C ;
Thomas, JM .
BRITISH JOURNAL OF SURGERY, 2005, 92 (02) :246-252
[15]   Is there a role for incomplete resection in the management of retroperitoneal liposarcomas? [J].
Shibata, D ;
Lewis, JJ ;
Leung, DH ;
Brennan, MF .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2001, 193 (04) :373-379
[16]   Retroperitoneal sarcomas: patterns of care in advanced stages, prognostic factors and focus on main histological subtypes: a multicenter analysis of the French Sarcoma Group [J].
Toulmonde, M. ;
Bonvalot, S. ;
Ray-Coquard, I. ;
Stoeckle, E. ;
Riou, O. ;
Isambert, N. ;
Bompas, E. ;
Penel, N. ;
Delcambre-Lair, C. ;
Saada, E. ;
Lecesne, A. ;
Le Pechoux, C. ;
Blay, J. Y. ;
Piperno-Neumann, S. ;
Chevreau, C. ;
Bay, J. O. ;
Brouste, V. ;
Terrier, P. ;
Ranchere-Vince, D. ;
Neuville, A. ;
Italiano, A. .
ANNALS OF ONCOLOGY, 2014, 25 (03) :730-734
[17]   Effectiveness of palliative procedures for intra-abdominal sarcomas [J].
Yeh, JJ ;
Singer, S ;
Brennan, MF ;
Jaques, DP .
ANNALS OF SURGICAL ONCOLOGY, 2005, 12 (12) :1084-1089
[18]   The role and outcomes of palliative surgery for retroperitoneal sarcoma [J].
Zerhouni, Siham ;
Van Coevorden, Frits ;
Swallow, Carol J. .
JOURNAL OF SURGICAL ONCOLOGY, 2018, 117 (01) :105-110