Contraindication to surgery in primary retroperitoneal sarcoma: Retrospective series on 20 years of practice in a high-volume sarcoma center

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery Pub Date : 2025-04-01 DOI:10.1016/j.jviscsurg.2025.01.009

Belkacem Acidi , Matthieu Faron , Olivier Mir , Antonin Levy , Mohammed Ghallab , Ines Kasraoui , Benjamin Verret , Cecile Le Péchoux , Raslislav Bahleda , Andrea Cavalcanti , Axel Le Cesne , Charles Honoré

{"title":"Contraindication to surgery in primary retroperitoneal sarcoma: Retrospective series on 20 years of practice in a high-volume sarcoma center","authors":"Belkacem Acidi , Matthieu Faron , Olivier Mir , Antonin Levy , Mohammed Ghallab , Ines Kasraoui , Benjamin Verret , Cecile Le Péchoux , Raslislav Bahleda , Andrea Cavalcanti , Axel Le Cesne , Charles Honoré","doi":"10.1016/j.jviscsurg.2025.01.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Surgery is the cornerstone treatment for retroperitoneal sarcomas (RPS). However, contraindications for unresectability are not well-documented in the literature.</div></div><div><h3>Aim of the study</h3><div>This study aims to identify contraindications that prevent surgery for primary RPS in a high-volume sarcoma center.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed all consecutive patients treated for primary RPS at our center from 1995 to 2021.</div></div><div><h3>Results</h3><div>Among the 452 patients treated for primary RPS, 92 (20%) were not offered surgery. The reasons for unresectability were categorized as follows: poor general health or severe comorbidities in 39 patients (42%), preoperative detection of distant metastases in 33 patients (36%), and locally advanced disease in 20 patients (22%). Locally advanced disease included vascular involvement in 14 patients (15%) and vertebral invasion in 6 patients (7%). Among the non-operated patients, 66% received chemotherapy, 16% received radiotherapy, and 5% received combined treatments. The median progression-free survival was 7months, and the median overall survival was 18months. The 1-year overall survival rate was 53%.</div></div><div><h3>Conclusion</h3><div>Contraindications for surgery in patients with primary RPS in a high-volume sarcoma center are not uncommon. The next step should be to differentiate absolute from relative (i.e., preoperative modifiable factors) contraindications.</div></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"162 2","pages":"Pages 111-116"},"PeriodicalIF":2.0000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Visceral Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1878788625000098","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Surgery is the cornerstone treatment for retroperitoneal sarcomas (RPS). However, contraindications for unresectability are not well-documented in the literature.

Aim of the study

This study aims to identify contraindications that prevent surgery for primary RPS in a high-volume sarcoma center.

Methods

We retrospectively analyzed all consecutive patients treated for primary RPS at our center from 1995 to 2021.

Results

Among the 452 patients treated for primary RPS, 92 (20%) were not offered surgery. The reasons for unresectability were categorized as follows: poor general health or severe comorbidities in 39 patients (42%), preoperative detection of distant metastases in 33 patients (36%), and locally advanced disease in 20 patients (22%). Locally advanced disease included vascular involvement in 14 patients (15%) and vertebral invasion in 6 patients (7%). Among the non-operated patients, 66% received chemotherapy, 16% received radiotherapy, and 5% received combined treatments. The median progression-free survival was 7 months, and the median overall survival was 18 months. The 1-year overall survival rate was 53%.

Conclusion

Contraindications for surgery in patients with primary RPS in a high-volume sarcoma center are not uncommon. The next step should be to differentiate absolute from relative (i.e., preoperative modifiable factors) contraindications.

查看原文本刊更多论文

原发性腹膜后肉瘤手术禁忌症：一个大容量肉瘤中心20年的回顾性研究。

手术是腹膜后肉瘤（RPS）的基础治疗。然而，不可切除的禁忌症在文献中并没有很好的记录。研究目的：本研究旨在确定在大容量肉瘤中心预防原发性RPS手术的禁忌症。方法：我们回顾性分析1995年至2021年在我们中心接受原发性RPS治疗的所有连续患者。结果：在452例原发性RPS患者中，92例（20%）未进行手术治疗。不可切除的原因如下：39例（42%）患者一般健康状况不佳或严重合并症，33例（36%）患者术前发现远处转移，20例（22%）患者局部疾病进展。局部晚期疾病包括14例（15%）血管受累，6例（7%）椎体受累。非手术患者中66%接受化疗，16%接受放疗，5%接受联合治疗。中位无进展生存期为7个月，中位总生存期为18个月。1年总生存率为53%。结论：大容量肉瘤中心原发性RPS患者的手术禁忌症并不少见。下一步应该区分绝对禁忌症和相对禁忌症（即术前可改变的因素）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Visceral Surgery SURGERY-

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.