Morbidity and Outcomes After Distal Pancreatectomy for Primary Retroperitoneal Sarcoma: An Analysis by the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group.

Autor: Bagaria SP; Department of Surgery, Mayo Clinic, Jacksonville, FL, USA. bagaria.sanjay@mayo.edu., Swallow C; Department of Surgery, Mount Sinai Hospital and Princess Margaret Cancer Center, Toronto, Canada., Suraweera H; Department of Surgery, Mount Sinai Hospital and Princess Margaret Cancer Center, Toronto, Canada., Raut CP; Division of Surgical Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA, USA., Fairweather M; Division of Surgical Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA, USA., Cananzi F; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy., Quagliuolo V; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; Sarcoma, Melanoma and Rare Tumors Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy., Grignani G; Candiolo Cancer Institute, FPO-IRCCS, Str. Prov.le 142, Candiolo, Italy., Hompes D; Department of Surgical Oncology, University Hospitals Gasthuisberg, Leuven, Belgium., Ford SJ; Department of Surgery, University Hospitals Birmingham, Birmingham, UK., Nessim C; Department of Surgery, University of Ottawa, Ottawa, Canada., Apte S; Department of Surgery, University of Ottawa, Ottawa, Canada., Skoczylas J; Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland., Rutkowski P; Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland., Bonvalot S; Department of Surgery, Institut Curie, Paris, France., Tzanis D; Department of Surgery, Institut Curie, Paris, France., Gabriel E; Department of Surgery, Mayo Clinic, Jacksonville, FL, USA., Pennacchioli E; Division of Melanoma, Sarcomas and Rare Tumors, IEO, European Institute of Oncology, IRCCS, Milan, Italy., Albertsmeier M; Department of General, Visceral, and Transplantation Surgery, Ludwig Maximilians Universitat Munich, Munich, Germany., Canter RJ; Department of Surgery, University of California-Davis School of Medicine, Sacramento, CA, USA., Pollock R; Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA., Grignol V; Division of Surgical Oncology, The Ohio State University, Columbus, OH, USA., Cardona K; Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA., Gamboa AC; Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA., Novak M; Department of Surgical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia., Stoeckle E; Department of Surgery, Institut Bergonie, Bordeaux, France., Almquist M; Department of Surgery, Skane University Hospital, Lund University, Lund, Sweden., Ahuja N; Department of Surgery, Smilow Cancer Institute, Yale University School of Medicine, New Haven, CT, USA., Klemen N; Department of Surgery, Smilow Cancer Institute, Yale University School of Medicine, New Haven, CT, USA., Van Houdt W; Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands., Gyorki D; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Gangi A; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia., Rastrelli M; Department of Surgical Oncology, Veneto Institute of Oncology, Padua, Italy., van der Hage J; Department of Surgery, Leiden University Medical Center, Leiden, Netherlands., Schrage Y; Department of Surgery, Leiden University Medical Center, Leiden, Netherlands., Valeri S; Department of Surgery, Campus Bio-Medico, Rome, Italy., Conti L; Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Spiegel MR; Department of Surgery, Mayo Clinic, Jacksonville, FL, USA., Li Z; Department of Surgery, Mayo Clinic, Jacksonville, FL, USA., Fiore M; Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Gronchi A; Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2021 Oct; Vol. 28 (11), pp. 6882-6889. Date of Electronic Publication: 2021 Mar 19.
DOI: 10.1245/s10434-021-09739-9
Abstrakt: Background: Multi-visceral resection often is used in the treatment of retroperitoneal sarcoma (RPS). The morbidity after distal pancreatectomy for primary pancreatic cancer is well-documented, but the outcomes after distal pancreatectomy for primary RPS are not. This study aimed to evaluate morbidity and oncologic outcomes after distal pancreatectomy for primary RPS.
Methods: In this study, 26 sarcoma centers that are members of the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) retrospectively identified consecutive patients who underwent distal pancreatectomy for primary RPS from 2008 to 2017. The outcomes measured were 90-day severe complications (Clavien-Dindo ≥ 3), postoperative pancreatic fistula (POPF) rate, and oncologic outcomes.
Results: Between 2008 and 2017, 280 patients underwent distal pancreatectomy for primary RPS. The median tumor size was 25 cm, and the median number of organs resected, including the pancreas, was three. In 96% of the operations, R0/R1 resection was achieved. The 90-day severe complication rate was 40 %. The grades B and C POPF complication rates were respectively 19% and 5% and not associated with worse overall survival. Administration of preoperative radiation and factors to mitigate POPF did not have an impact on the risk for the development of a POPF. The RPS invaded the pancreas in 38% of the patients, and local recurrence was doubled for the patients who had a microscopic, positive pancreas margin (hazard ratio, 2.0; p = 0.042).
Conclusion: Distal pancreatectomy for primary RPS has acceptable morbidity and oncologic outcomes and is a reasonable approach to facilitate complete tumor resection.
(© 2021. Society of Surgical Oncology.)
Databáze: MEDLINE
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