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Published on: May 10, 2021
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Intraoperative motive for incomplete resection in primary retroperitoneal sarcoma
1Department of Surgical Oncology, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
Summary
Incomplete resection (R2) for retroperitoneal sarcoma (RPS) is rare, occurring in 3.7% of cases. Intraoperative findings like vascular involvement or unexpected metastases were key reasons for non-curative surgery.
Area of Science:
- Oncology
- Surgical Oncology
- Sarcoma Research
Background:
- Surgical resection is the standard treatment for retroperitoneal sarcoma (RPS).
- Incomplete (R2) resection rates for RPS can be up to 5%.
- Reasons for incomplete RPS resection are not well understood.
Purpose of the Study:
- To identify intraoperative findings leading to incomplete (R2) resection in primary RPS.
- To analyze factors contributing to non-curative surgical outcomes in RPS patients.
Main Methods:
- Retrospective analysis of 347 patients undergoing primary RPS surgery (1995-2020).
- Focus on patients with non-metastatic disease scheduled for curative-intent resection.
- Inclusion criteria: tertiary care sarcoma center data.
Main Results:
- 13 patients (3.7%) had incomplete (R2) resection.
- Reasons included vascular involvement (5), peritoneal metastases (5), kidney/ureter invasion (2), and bilateral kidney preservation need (1).
- Post-incomplete resection survival rates were significantly lower (1-year OS 46%, 5-year OS 14%).
Conclusions:
- Incomplete RPS resection is infrequent in specialized centers.
- Further research needed to identify preoperative criteria for selecting resectable cases.
- Establish best practices for managing unresectable RPS discovered intraoperatively.
