Surgical and reconstructive outcomes in primary venous leiomyosarcoma

Area of Science:

• Vascular Surgery
• Surgical Oncology
• Rare Cancers

Background:

• Primary venous leiomyosarcomas (PVL) are uncommon malignancies.
• Surgical management of PVL, particularly in the inferior vena cava (IVC), presents significant challenges.
• Limited data exists on the long-term outcomes and survival predictors for PVL.

Purpose of the Study:

• To evaluate clinical outcomes in a surgical series of PVL.
• To identify predictors of survival in patients with PVL.
• To compare outcomes between IVC and peripheral PVL.

Main Methods:

• Retrospective review of 70 patients with PVL between 1990 and 2018 across three centers.
• Data collected included demographics, comorbidities, intraoperative details, survival, and graft outcomes.
• Survival analysis utilized Kaplan-Meier curves and Cox proportional hazards regression.

Main Results:

• 54 patients (77%) had IVC-PVL, 16 (23%) had peripheral PVL. Mean follow-up was 55 months.
• 5-year survival was 57.5% for IVC-PVL and 70.0% for peripheral PVL.
• No significant difference in overall 5-year survival was observed between IVC and peripheral PVL (P = .624).

Conclusions:

• PVL is a rare and aggressive tumor requiring prompt surgical intervention.
• Aggressive management is indicated for both IVC and peripheral PVL, as survival rates are comparable.
• A multidisciplinary approach is essential for optimizing long-term outcomes in PVL patients.