TY - JOUR
T1 - Postoperative Morbidity After Resection of Recurrent Retroperitoneal Sarcoma
T2 - A Report from the Transatlantic Australasian RPS Working Group (TARPSWG)
AU - Nessim, Carolyn
AU - Raut, Chandrajit P.
AU - Callegaro, Dario
AU - Barretta, Francesco
AU - Miceli, Rosalba
AU - Fairweather, Mark
AU - Rutkowski, Piotr
AU - Blay, Jean Yves
AU - Strauss, Dirk
AU - Gonzalez, Ricardo
AU - Ahuja, Nita
AU - Grignani, Giovanni
AU - Quagliuolo, Vittorio
AU - Stoeckle, Eberhard
AU - De Paoli, Antonino
AU - Pillarisetty, Venu G.
AU - Swallow, Carol J.
AU - Bagaria, Sanjay P.
AU - Canter, Robert J.
AU - Mullen, John T.
AU - Schrage, Yvonne
AU - Pennacchioli, Elisabetta
AU - van Houdt, Winan
AU - Cardona, Kenneth
AU - Fiore, Marco
AU - Gronchi, Alessandro
AU - Lahat, Guy
N1 - Funding Information:
Dr. Nita Ahuja has received grant funding from Cepheid and Astex and has served as consultant to Ethicon. She has licensed methylation biomarkers to Cepheid. Dr. Giovanni Grignani has received grants from Pharmamar, Bayer, Novartis Board participation, Pharmamar, Bayer, Novartis, Pfizer, EISAI, and Merck. The remaining authors have no conflicts of interest.
Publisher Copyright:
© 2021, Society of Surgical Oncology.
PY - 2021/5
Y1 - 2021/5
N2 - Background: This study aimed to evaluate perioperative morbidity after surgery for first locally recurrent (LR1) retroperitoneal sarcoma (RPS). Data concerning the safety of resecting recurrent RPS are lacking. Methods: Data were collected on all patients undergoing resection of RPS-LR1 at 22 Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) centers from 2002 to 2011. Uni- and multivariable logistic models were fitted to study the association between major (Clavien-Dindo grade ≥ 3) complications and patient/surgery characteristics as well as outcome. The resected organ score, a method of standardizing the number of organs resected, as previously described by the TARPSWG, was used. Results: The 681 patients in this study had a median age of 59 years, and 51.8% were female. The most common histologic subtype was de-differentiated liposarcoma (43%), the median resected organ score was 1, and 83.3% of the patients achieved an R0 or R1 resection. Major complications occurred for 16% of the patients, and the 90-day mortality rate was 0.4%. In the multivariable analysis, a transfusion requirement was found to be a significant predictor of major complications (p < 0.001) and worse overall survival (OS) (p = 0.010). However, having a major complication was not associated with a worse OS or a higher incidence of local recurrence or distant metastasis. Conclusions: A surgical approach to recurrent RPS is relatively safe and comparable with primary RPS in terms of complications and postoperative mortality when performed at specialized sarcoma centers. Because alternative effective therapies still are lacking, when indicated, resection of a recurrent RPS is a reasonable option. Every effort should be made to minimize the need for blood transfusions.
AB - Background: This study aimed to evaluate perioperative morbidity after surgery for first locally recurrent (LR1) retroperitoneal sarcoma (RPS). Data concerning the safety of resecting recurrent RPS are lacking. Methods: Data were collected on all patients undergoing resection of RPS-LR1 at 22 Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) centers from 2002 to 2011. Uni- and multivariable logistic models were fitted to study the association between major (Clavien-Dindo grade ≥ 3) complications and patient/surgery characteristics as well as outcome. The resected organ score, a method of standardizing the number of organs resected, as previously described by the TARPSWG, was used. Results: The 681 patients in this study had a median age of 59 years, and 51.8% were female. The most common histologic subtype was de-differentiated liposarcoma (43%), the median resected organ score was 1, and 83.3% of the patients achieved an R0 or R1 resection. Major complications occurred for 16% of the patients, and the 90-day mortality rate was 0.4%. In the multivariable analysis, a transfusion requirement was found to be a significant predictor of major complications (p < 0.001) and worse overall survival (OS) (p = 0.010). However, having a major complication was not associated with a worse OS or a higher incidence of local recurrence or distant metastasis. Conclusions: A surgical approach to recurrent RPS is relatively safe and comparable with primary RPS in terms of complications and postoperative mortality when performed at specialized sarcoma centers. Because alternative effective therapies still are lacking, when indicated, resection of a recurrent RPS is a reasonable option. Every effort should be made to minimize the need for blood transfusions.
UR - http://www.scopus.com/inward/record.url?scp=85098491664&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85098491664&partnerID=8YFLogxK
U2 - 10.1245/s10434-020-09445-y
DO - 10.1245/s10434-020-09445-y
M3 - Article
C2 - 33389288
AN - SCOPUS:85098491664
SN - 1068-9265
VL - 28
SP - 2705
EP - 2714
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 5
ER -