Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review
Abstract Background and aim Surgery is the mainstay of treatment and completeness of surgical resection is critical to achieve local control for retroperitoneal sarcoma (RPS). En-bloc resection of adjacent organs, including major abdominal vessels, is often required to achieve negative margins. The...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-023-02178-1 |
| _version_ | 1827724973772374016 |
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| author | Hankui Hu Qiang Guo Jichun Zhao Bin Huang Xiaojiong Du |
| author_facet | Hankui Hu Qiang Guo Jichun Zhao Bin Huang Xiaojiong Du |
| author_sort | Hankui Hu |
| collection | DOAJ |
| description | Abstract Background and aim Surgery is the mainstay of treatment and completeness of surgical resection is critical to achieve local control for retroperitoneal sarcoma (RPS). En-bloc resection of adjacent organs, including major abdominal vessels, is often required to achieve negative margins. The aim of this review was to summarise the available evidence to assess the relative benefits and disadvantages of an aggressive surgical approach with vascular resection in patients with retroperitoneal sarcoma (RPS). Methods We searched PubMed, the Cochrane Library, and EMBASE for relevant studies published from inception up to August 1, 2022. We performed a systematic review of the available studies to assess the safety and long-term survival results of vascular resection for RPS. Results We identified a total of 23 studies for our review. Overall postoperative in-hospital or 30-day mortality rate of patients with primary iliocaval leiomyosarcoma was 3% (11/359), and the major complication rate was 13%. The recurrence-free survival (RFS) rates after the follow-up period varied between 15% and 52%, and the 5-year overall survival (OS) rates ranged from 25 to 78%. Overall postoperative in-hospital or 30-day mortality rate of patients with RPSs receiving vascular resection was 3%, and the major complication rate was 27%. The RFS rates after the follow-up period were 18–86%, and the 5-year OS rates varied between 50% and 73%. There were no significant differences in the rates of RFS (HR: 0.97; 95% CI: 0.74–1.19; p = 0.945) and OS (HR: 1.01; 95% CI: 0.66–1.36; p = 0.774) between the extended resection group and tumour resection alone group. Conclusions With adequate preparation and proper management, for patients with RPSs involving major vessels, aggressive surgical approach with vascular resection can achieve R0/R1 resection and improve survival. |
| first_indexed | 2024-03-10T22:21:57Z |
| format | Article |
| id | doaj.art-28fa2a1570614d9b9099f9548a7dc620 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-10T22:21:57Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-28fa2a1570614d9b9099f9548a7dc6202023-11-19T12:13:26ZengBMCBMC Surgery1471-24822023-09-0123111010.1186/s12893-023-02178-1Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic reviewHankui Hu0Qiang Guo1Jichun Zhao2Bin Huang3Xiaojiong Du4Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityAbstract Background and aim Surgery is the mainstay of treatment and completeness of surgical resection is critical to achieve local control for retroperitoneal sarcoma (RPS). En-bloc resection of adjacent organs, including major abdominal vessels, is often required to achieve negative margins. The aim of this review was to summarise the available evidence to assess the relative benefits and disadvantages of an aggressive surgical approach with vascular resection in patients with retroperitoneal sarcoma (RPS). Methods We searched PubMed, the Cochrane Library, and EMBASE for relevant studies published from inception up to August 1, 2022. We performed a systematic review of the available studies to assess the safety and long-term survival results of vascular resection for RPS. Results We identified a total of 23 studies for our review. Overall postoperative in-hospital or 30-day mortality rate of patients with primary iliocaval leiomyosarcoma was 3% (11/359), and the major complication rate was 13%. The recurrence-free survival (RFS) rates after the follow-up period varied between 15% and 52%, and the 5-year overall survival (OS) rates ranged from 25 to 78%. Overall postoperative in-hospital or 30-day mortality rate of patients with RPSs receiving vascular resection was 3%, and the major complication rate was 27%. The RFS rates after the follow-up period were 18–86%, and the 5-year OS rates varied between 50% and 73%. There were no significant differences in the rates of RFS (HR: 0.97; 95% CI: 0.74–1.19; p = 0.945) and OS (HR: 1.01; 95% CI: 0.66–1.36; p = 0.774) between the extended resection group and tumour resection alone group. Conclusions With adequate preparation and proper management, for patients with RPSs involving major vessels, aggressive surgical approach with vascular resection can achieve R0/R1 resection and improve survival.https://doi.org/10.1186/s12893-023-02178-1Retroperitoneal sarcomaSurgeryVascular resectionOverall survivalSystematic review |
| spellingShingle | Hankui Hu Qiang Guo Jichun Zhao Bin Huang Xiaojiong Du Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review BMC Surgery Retroperitoneal sarcoma Surgery Vascular resection Overall survival Systematic review |
| title | Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review |
| title_full | Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review |
| title_fullStr | Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review |
| title_full_unstemmed | Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review |
| title_short | Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review |
| title_sort | aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas a systematic review |
| topic | Retroperitoneal sarcoma Surgery Vascular resection Overall survival Systematic review |
| url | https://doi.org/10.1186/s12893-023-02178-1 |
| work_keys_str_mv | AT hankuihu aggressivesurgicalapproachwithvascularresectionandreconstructionforretroperitonealsarcomasasystematicreview AT qiangguo aggressivesurgicalapproachwithvascularresectionandreconstructionforretroperitonealsarcomasasystematicreview AT jichunzhao aggressivesurgicalapproachwithvascularresectionandreconstructionforretroperitonealsarcomasasystematicreview AT binhuang aggressivesurgicalapproachwithvascularresectionandreconstructionforretroperitonealsarcomasasystematicreview AT xiaojiongdu aggressivesurgicalapproachwithvascularresectionandreconstructionforretroperitonealsarcomasasystematicreview |