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Tytuł:
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Radical excision for retroperitoneal soft tissue sarcoma: A national propensity-matched outcomes analysis.
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Autorzy:
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Villano AM; MedStar-Georgetown Surgical Outcomes Research Center, Washington, DC; Department of Surgery, MedStar-Georgetown University Hospital, Washington, DC.
Zeymo A; MedStar-Georgetown Surgical Outcomes Research Center, Washington, DC; MedStar Health Research Institute, Hyattsville, MD.
Nigam A; MedStar-Georgetown Surgical Outcomes Research Center, Washington, DC; Department of Surgery, MedStar-Georgetown University Hospital, Washington, DC.
Chan KS; MedStar-Georgetown Surgical Outcomes Research Center, Washington, DC; MedStar Health Research Institute, Hyattsville, MD; Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC.
Shara N; MedStar Health Research Institute, Hyattsville, MD; Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC.
Unger KR; Department of Radiation Oncology, MedStar-Georgetown University Hospital, Washington, DC.
Al-Refaie WB; MedStar-Georgetown Surgical Outcomes Research Center, Washington, DC; Department of Surgery, MedStar-Georgetown University Hospital, Washington, DC; MedStar Health Research Institute, Hyattsville, MD. Electronic address: .
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Źródło:
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Surgery [Surgery] 2020 Nov; Vol. 168 (5), pp. 831-837. Date of Electronic Publication: 2020 Jul 21.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: St. Louis, MO : Mosby
Original Publication: St. Louis.
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MeSH Terms:
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Propensity Score*
Retroperitoneal Neoplasms/*surgery
Sarcoma/*surgery
Adult ; Aged ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Retroperitoneal Neoplasms/mortality ; Retroperitoneal Neoplasms/pathology ; Sarcoma/mortality ; Sarcoma/pathology
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Entry Date(s):
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Date Created: 20200726 Date Completed: 20201113 Latest Revision: 20201113
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Update Code:
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20240104
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DOI:
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10.1016/j.surg.2020.05.031
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PMID:
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32709488
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Background: Given the rarity of retroperitoneal soft tissue sarcoma, few studies have assessed if radical excision of retroperitoneal soft tissue sarcoma with adjacent organs improves survival outcomes. This propensity score-matched study aimed to evaluate the impact of radical excision versus resection of tumor alone.
Methods: The National Cancer Database 2004 to 2015 was used to assess short- and long-term outcomes of resection of tumor alone versus radical excision (tumor plus ≥1 adjacent organs) via 1:1 propensity-matched analyses. Subgroup analyses included low-grade, high-grade, liposarcoma, leiomyosarcoma, adjacent organ involvement alone, localized tumors alone, and high-volume hospitals (≥10 resections/y). Multivariable logistic regression models identified factors associated with radical excision.
Results: Comparison of propensity-matched groups (N = 1,139/group) revealed no significant differences in 30-day mortality, 90-day mortality, or overall survival (for all, P > .580). For all subgroup analyses comparing resection of tumor alone with radical excision, including localized tumors without organ invasion (N = 208/group), there were no identified differences in short- or long-term survival. Although it yielded lower R2 resection rates (P = .007), radical excision was associated with greater mean length of stay (P < .001).
Conclusion: Radical excision was not associated with improved retroperitoneal soft tissue sarcoma survival irrespective of grade, histology, hospital volume, or adjacent organ involvement. Resection of ostensibly involved adjacent viscera may increase morbidity without survival benefit. These results inform ongoing discussion regarding histology-tailored, situation-specific extent of retroperitoneal soft tissue sarcoma resections.
(Copyright © 2020. Published by Elsevier Inc.)
