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Inferior vena cava leiomyosarcoma: is reconstruction necessary after resection?
Rouzbeh Daylami1, Amir Amiri, Brian Goldsmith
1Department of Surgery, University of California Davis Medical Center, Sacramento, CA.
Journal of the American College of Surgeons
|February 2, 2010
Summary
Inferior vena cava (IVC) leiomyosarcomas are rare but treatable. Surgical resection without IVC reconstruction is feasible for tumors below hepatic veins, with manageable complications like edema and transient renal failure.
Area of Science:
- Oncology
- Vascular Surgery
- Sarc o ma Research
Background:
- Inferior vena cava (IVC) leiomyosarcomas are rare soft-tissue sarcomas.
- Limited experience necessitates varied management strategies.
- Uncertainty exists regarding multimodality therapy and IVC reconstruction necessity.
Purpose of the Study:
- To evaluate the outcomes of surgical resection for IVC leiomyosarcomas.
- To assess the necessity of IVC reconstruction after tumor resection.
- To analyze complications associated with IVC leiomyosarcoma treatment.
Main Methods:
- Retrospective review of six patients with IVC leiomyosarcomas over six years.
- Analysis of demographic data, imaging, pathology, and treatment regimens.
- Comparison of institutional outcomes with published data.
Main Results:
- All six patients underwent en bloc resection after preoperative radiation (4,500–5,000 cGy).
- Four patients (66%) achieved R0 resection; all tumors were high grade.
- No IVC reconstruction was performed; common complications included lower-extremity edema (50%) and transient acute renal failure (50%).
Conclusions:
- IVC leiomyosarcoma is a treatable malignancy.
- Preoperative radiation may aid resection, but survival benefit requires further study.
- IVC reconstruction is often unnecessary for tumors below hepatic veins; edema and transient renal failure are manageable complications.
