共 18 条
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.
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页码:1140 / 1147
页数:8
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