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Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review

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 t...

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Autores principales: Hu, Hankui, Guo, Qiang, Zhao, Jichun, Huang, Bin, Du, Xiaojiong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498574/
https://www.ncbi.nlm.nih.gov/pubmed/37700246
http://dx.doi.org/10.1186/s12893-023-02178-1
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author Hu, Hankui
Guo, Qiang
Zhao, Jichun
Huang, Bin
Du, Xiaojiong
author_facet Hu, Hankui
Guo, Qiang
Zhao, Jichun
Huang, Bin
Du, Xiaojiong
author_sort Hu, Hankui
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-023-02178-1.
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spelling pubmed-104985742023-09-14 Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review Hu, Hankui Guo, Qiang Zhao, Jichun Huang, Bin Du, Xiaojiong BMC Surg Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-023-02178-1. BioMed Central 2023-09-12 /pmc/articles/PMC10498574/ /pubmed/37700246 http://dx.doi.org/10.1186/s12893-023-02178-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Hu, Hankui
Guo, Qiang
Zhao, Jichun
Huang, Bin
Du, Xiaojiong
Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a 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 Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498574/
https://www.ncbi.nlm.nih.gov/pubmed/37700246
http://dx.doi.org/10.1186/s12893-023-02178-1
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