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Nephrectomy during operative management of retroperitoneal sarcoma.

Abstract：

BACKGROUND:Complete resection of a retroperitoneal sarcoma often requires removal of adjacent organs. In this study we evaluated the role of nephrectomy during operation for retroperitoneal sarcoma. METHODS:Between July 1982 and July 1995, 75 of the 371 (20%) patients who underwent resection of retroperitoneal sarcoma at MSKCC underwent concommitant nephrectomy. Data concerning the reasons for nephrectomy, degree of sarcomatous renal involvement, and survival were retrospectively analyzed. RESULTS:Fifty-four patients (72%) underwent nephrectomy during the initial resection, and 21 (28%) during a resection of a recurrent or persistent tumor. The most common reason for nephrectomy was total encasement by sarcoma (n = 40; 53%), followed by dense adherence of the tumor to the kidney (n = 21; 28%), and the direct invasion of the kidney by tumor (n = 2; 3%). Pathology demonstrated an absence of kidney invasion in the majority of cases (55 of 75; 73%). Renal capsular invasion was present in 11 of 75 (15%), renal parenchymal invasion in 7 of 75 (9%), and renal vein invasion in 2 of 75 (3%) of cases. There were no significant differences in survival based on degree of sarcoma involvement of the kidney, tumor grade, or whether the resection was for primary or recurrent disease. The 53 patients who underwent a complete gross resection of all tumor had a significantly improved long-term survival compared to the 20 patients who did not (50% versus 20% DFS at 5 years, respectively; p < 0.001). CONCLUSIONS:Decisions for concomitant nephrectomy during resection of retroperitoneal sarcoma should be based on whether this maneuver will provide a complete resection of all gross tumor, in which case the long-term disease-free survival of 50% is comparable to the reported 5-year survival of all patients with retroperitoneal sarcoma who are completely resected.

journal_name

Ann Surg Oncol

journal_title

Annals of surgical oncology

authors

Russo P,Kim Y,Ravindran S,Huang W,Brennan MF

doi

10.1007/BF02305556

subject

Has Abstract

pub_date

1997-07-01 00:00:00

pages

421-4

issue

5

eissn

1068-9265

issn

1534-4681

journal_volume

4

pub_type

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