Retroperitoneal soft tissue sarcomas: Predictive factors for incomplete resection

IF 2 4区 医学 Q2 SURGERY Journal of Visceral Surgery Pub Date : 2024-04-01 DOI:10.1016/j.jviscsurg.2023.10.002
Pierre-Olivier Jouppe , Nicolas Regenet , Ephrem Salame , Matthias Tallegas , Aymeric Amelot , Arthur David , Nicolas Michot
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Abstract

Introduction

Curative management of retroperitoneal sarcoma relies on surgery, and complete monoblock resection is one of the main prognostic factors. The goal of this study was to search predictive factors for incomplete resection.

Methods

All patients undergoing surgery for retroperitoneal sarcoma in two University hospitals between 2010 and 202 were included. The main endpoint was incomplete resection (R1 ad R2) after surgery. Secondary analysis was performed where marginal R0 resection was considered as complete. Univariate and multivariable analysis of demographics, radiological, surgical and pathologic criteria were performed. Overall survival, local and distant recurrence were evaluated.

Results

Fifty-eight patients were included in the study. Fifty patients had incomplete resection, of which seven had marginal R0 resection. In multivariable analysis, none of the factors analyzed were associated with incomplete resection. In secondary analysis, undifferentiated liposarcoma histology (OR 12.3, 95% CI [1.416–107.303], P = 0.023) was statistically significantly associated with incomplete resection. Low grade (grade I) histology was predictive of complete resection (OR 0.24, 95% CI [0.060–0.959], P = 0.043). Median follow-up duration was 27 months. Local and distant recurrence rates at three years were 37% and 22.4%, respectively.

Conclusion

In this study, we highlighted several predictive factors for incomplete resection. These factors enable us to define target populations that could most benefit from complementary therapy along with surgery.

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腹膜后软组织肉瘤:不完全切除的预测因素
导言腹膜后肉瘤的治愈主要依靠手术,而完整的单块切除是主要的预后因素之一。本研究旨在寻找不完全切除的预测因素。方法纳入 2010 年至 202 年间在两所大学医院接受腹膜后肉瘤手术的所有患者。主要终点是术后不完全切除(R1 和 R2)。二次分析将边缘R0切除视为完全切除。对人口统计学、放射学、手术和病理学标准进行了单变量和多变量分析。对总生存率、局部和远处复发进行了评估。研究共纳入了 58 例患者,其中 50 例患者切除不完全,7 例为边缘 R0 切除。在多变量分析中,所分析的因素均与不完全切除无关。在二次分析中,未分化脂肪肉瘤组织学(OR 12.3,95% CI [1.416-107.303],P = 0.023)与不完全切除有显著统计学相关性。低级别(I级)组织学可预测完全切除(OR 0.24,95% CI [0.060-0.959],P = 0.043)。中位随访时间为 27 个月。三年后的局部和远处复发率分别为 37% 和 22.4%。结论在这项研究中,我们强调了几种不完全切除的预测因素,这些因素使我们能够确定哪些目标人群最能从手术的辅助治疗中获益。
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来源期刊
CiteScore
2.00
自引率
9.50%
发文量
108
审稿时长
>12 weeks
期刊介绍: The Journal of Visceral Surgery (JVS) is the online-only, English version of the French Journal de Chirurgie Viscérale. The journal focuses on clinical research and continuing education, and publishes original and review articles related to general surgery, as well as press reviews of recently published major international works. High-quality illustrations of surgical techniques, images and videos serve as support for clinical evaluation and practice optimization. JVS is indexed in the main international databases (including Medline) and is accessible worldwide through ScienceDirect and ClinicalKey.
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