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Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma

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Oncovascular surgery for advanced pelvic malignancy.

Saissan Rajendran^1,2,3, Kilian G M Brown^2,3,4,5, Michael J Solomon^2,3,4,5

¹Department of Vascular Surgery, Concord Repatriation General Hospital, Sydney, Australia.

The British Journal of Surgery

|November 25, 2022

Summary

Extended radical resections for advanced pelvic tumors involving major vascular structures are feasible. Oncological and survival outcomes are comparable to central pelvic tumors, encouraging oncovascular experience development.

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Area of Science:

Oncology
Vascular Surgery
Surgical Oncology

Background:

Increasing expertise in extended radical resections for advanced pelvic tumors.
Growing use of complex vascular resections and reconstructions in specialized units.
Need for a review on surgical approaches for pelvic tumors with vascular involvement.

Approach:

Narrative review of published data on major vascular resection and reconstruction for advanced pelvic tumors.
Inclusion of preoperative evaluation, surgical techniques, and outcomes.
Discussion of treatment decisions, controversies, and future directions.

Key Points:

Major vascular resection and reconstruction involve prolonged operating times and significant blood loss.
R0 resection rates range from 58-82% in specialist units.
Complication risks and perioperative mortality are acceptable, with long-term survival around 50%.

Conclusions:

En bloc resection of iliac vessels is a feasible strategy for advanced pelvic tumors with vascular infiltration.
Oncological, morbidity, and survival outcomes are comparable to central pelvic tumors.
Increasing interest in extended pelvic resections will drive oncovascular experience growth.