Resection of Recurrent Pelvic Soft Tissue Sarcoma: Is the Risk Worth the Reward?

Autor: Mor E; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: eyal.mor@sheba.health.gov.il., Assaf D; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Shemla S; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Ben-Ami E; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Department of Oncology, Sheba Medical Center, Tel Hashomer, Israel., Mor-Hadar D; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel., Halfon M; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Laks S; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Hazzan D; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Perelson D; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Department of Anesthesiology, Sheba Medical Center, Tel Hashomer, Israel., Zippel D; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Ben-Yaacov A; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Nissan A; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel., Adileh M; The Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2023 Mar; Vol. 283, pp. 914-922. Date of Electronic Publication: 2022 Dec 08.
DOI: 10.1016/j.jss.2022.10.026
Abstrakt: Introduction: Soft tissue sarcomas (STS) of the pelvis present a surgical and oncological challenge. We investigated the outcomes of patients undergoing resection of pelvic sarcomas.
Methods: A retrospective analysis of all patients who underwent surgical resection for STS between 2014 and 2021 at a tertiary academic referral center (n = 172). Included all patients with primary or recurrent STS which originated or extended to the pelvic cavity (n = 29).
Results: The cohort was divided into primary pelvic sarcomas (n = 18) and recurrent pelvic sarcomas (rPS, n = 11). Complete R0/R1 resection was achieved in 26 patients (89.6%). The postoperative complication rate was 48.3%. The rate of major complications was 27.5%. The median time of follow-up from surgery was 12.3 months (range, 0.6-60.3 months). Disease-free survival was superior in the primary pelvic sarcomas group compared to the rPS group (P = 0.002). However, there was no significant difference in overall survival, (P = 0.52). Univariant and multivariant analyses identified rPS group (Hazard Ratio 8.68, P = 0.006) and resection margins (Hazard Ratio 6.29, P = 0.004) to be independently associated with disease-free survival.
Conclusions: We have demonstrated that achieving R0/R1 resection is feasible. Oncological outcomes are favorable for primary tumors, whereas recurrent tumors exhibit early recurrences. Consideration of resection of recurrent pelvic STS should involve a careful multidisciplinary evaluation.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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