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Postoperative Morbidity After Radical Resection of Primary Retroperitoneal Sarcoma: A Report From the Transatlantic RPS Working Group.

Abstract：

OBJECTIVE:To investigate the safety of radical resection for retroperitoneal sarcoma (RPS). BACKGROUND:The surgical management of RPS frequently involves complex multivisceral resection. Improved oncologic outcomes have been demonstrated with this approach compared to marginal excision, but the safety of radical resection has not been shown in a large study population. METHODS:The Transatlantic Retroperitoneal Sarcoma Working Group (TARPSWG) is an international collaborative of sarcoma centers. A combined experience of 1007 consecutive resections for primary RPS from January 2002 to December 2011 was studied retrospectively with respect to adverse events. A weighted organ score was devised to account for differences in surgical complexity. Univariate and multivariate logistic regression analyses were performed to investigate associations between adverse events and number and patterns of organs resected. Associations between adverse events and overall survival, local recurrence, and distant metastases were investigated. RESULTS:Severe postoperative adverse events (Clavien-Dindo ≥3) occurred in 165 patients (16.4%) and 18 patients (1.8%) died within 30 days. Significant predictors of severe adverse events were age (P = 0.003), transfusion requirements (P < 0.001), and resected organ score (P = 0.042). Resections involving pancreaticoduodenectomy, major vascular resection, and splenectomy/pancreatectomy were found to entail higher operative risk (odds ratio >1.5). There was no impact of postoperative adverse events on overall survival, local recurrence, or distant metastases. CONCLUSIONS:A radical surgical approach to RPS is safe when carried out at a specialist sarcoma center. High-risk resections should be carefully considered on an individual basis and weighed against anticipated disease biology. There appears to be no association between surgical morbidity and long-term oncologic outcomes.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

MacNeill AJ,Gronchi A,Miceli R,Bonvalot S,Swallow CJ,Hohenberger P,Van Coevorden F,Rutkowski P,Callegaro D,Hayes AJ,Honoré C,Fairweather M,Cannell A,Jakob J,Haas RL,Szacht M,Fiore M,Casali PG,Pollock RE,Barretta F,

doi

10.1097/SLA.0000000000002250

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

959-964

issue

eissn

0003-4932

issn

1528-1140

journal_volume

267

pub_type

杂志文章,多中心研究

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Postoperative Morbidity After Radical Resection of Primary Retroperitoneal Sarcoma: A Report From the Transatlantic RPS Working Group.