| Autor: |
Teixeira FJR Jr; Sarcoma and Melanoma Surgery Unit, São Paulo Cancer Institute, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil.; Department of General Surgery, Clinics Hospital, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil., do Couto Netto SD; Department of General Surgery, Clinics Hospital, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil., Perina ALF; Sarcoma and Melanoma Surgery Unit, São Paulo Cancer Institute, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil., Torricelli FCM; Department of Urology, Clinics Hospital, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil., Ragazzo Teixeira L; Department of Vascular Surgery, Clinics Hospital, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil., Zerati AE; Department of Vascular Surgery, Clinics Hospital, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil., Ferreira FO; Sarcoma and Melanoma Surgery Unit, São Paulo Cancer Institute, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil., Akaishi EH; Sarcoma and Melanoma Surgery Unit, São Paulo Cancer Institute, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil., Nahas WC; Department of Urology, Clinics Hospital, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil., Utiyama EM; Department of General Surgery, Clinics Hospital, University of São Paulo Medical School, Cerqueira César, SP 05403-000, Brazil. |
| Abstrakt: |
Leiomyosarcoma (LMS) of inferior vena cava (IVC) is a rare neoplasm affecting approximately 1/100,000 people. The prognosis is poor and potential curative intent occurs through challenging operations, such as vena cava resection, occasionally multivisceral when required, and vascular reconstruction. There are few retrospective series regarding this retroperitoneal neoplasm, and the aim of the present study was to discuss the experience at the São Paulo Cancer Institute and Clinics Hospital of University of São Paulo Medical School, São Paulo, Brazil. The current study is a retrospective review of 7 patients treated in the two tertiary hospitals between 2005 and 2013. Oncological and operative aspects were discussed, primarily regarding surgical aspects highlighting en bloc resection, vascular reconstruction, and the overall survival and recurrence rates. All the patients were treated with radical intent, 4 of whom underwent multivisceral resection, with the kidney being the most resected organ. The location of the IVC tumor was described using Kulaylat's description and the median tumor size was 10 cm. Vascular reconstruction was necessary in 4 patients. The overall survival rate at 3 and 5 years was 100, and 25%, respectively. The disease-free survival rate at 3 and 5 years was 57 and 20%, respectively. In conclusion, IVC LMS is a rare and severe retroperitoneal neoplasm, with multivisceral resections remaining a surgical challenge. The treatment requires numerous experienced surgeons and the impact of microscopic free margins remains unclear. Vascular reconstruction depends on several aspects regarding primarily the topography of the tumor. |
