Song H, Ahn JH, Jung Y, Woo JY, Cha J, Chung YG, Lee KH. Intra and extra pelvic multidisciplinary surgical approach of retroperitoneal sarcoma: Case series report. World J Clin Cases 2022; 10(27): 9693-9702 [PMID: 36186181 DOI: 10.12998/wjcc.v10.i27.9693]
Corresponding Author of This Article
Keun Ho Lee, MD, PhD, Professor, Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero Seochogu, Seoul 06591, South Korea. hohoho@catholic.ac.kr
Research Domain of This Article
Oncology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2022; 10(27): 9693-9702 Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9693
Intra and extra pelvic multidisciplinary surgical approach of retroperitoneal sarcoma: Case series report
Heekyoung Song, Jung Hwan Ahn, Yuyeon Jung, Jae Yeon Woo, Jimin Cha, Yang-Guk Chung, Keun Ho Lee
Heekyoung Song, Department of Obstetrics and Gynecology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
Jung Hwan Ahn, Yuyeon Jung, Jae Yeon Woo, Jimin Cha, Keun Ho Lee, Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
Yang-Guk Chung, Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, South Korea
Author contributions: Lee KH, Chung YG, and Song H designed this study; all other authors contributed to data collection; Song H, Ahn JH, Jung Y, Woo JY, and Cha J analyzed and interpreted the data, and Song H wrote the draft of the manuscript; Lee KH and Chung YG supervised and revised the manuscript for intellectual content.
Institutional review board statement: This study was approved by the institutional review board of Seoul St. Mary’s Hospital (approval number: KC20RISI0350).
Informed consent statement: The institutional review board waived the need for informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Keun Ho Lee, MD, PhD, Professor, Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpodaero Seochogu, Seoul 06591, South Korea. hohoho@catholic.ac.kr
Received: June 2, 2022 Peer-review started: June 2, 2022 First decision: July 14, 2022 Revised: July 18, 2022 Accepted: August 15, 2022 Article in press: August 15, 2022 Published online: September 26, 2022 Processing time: 105 Days and 21.7 Hours
Abstract
BACKGROUND
Retroperitoneal sarcoma (RPS) is a rare malignancy arising from mesenchymal cells that most commonly presents as an abdominal mass and is associated with poor prognosis. Although several studies have assessed the survival benefits of wide excision, few have reported detailed methods for achieving wide excision in patients with RPS.
AIM
To describe our experience with multidisciplinary surgical resection of RPS using intra- and extra-pelvic approaches.
METHODS
Multidisciplinary surgery is an anatomical approach that combines intra- and extra-peritoneal access within the same surgery to achieve complete RPS removal. This retrospective review of the records of patients who underwent multidisciplinary surgery for RPS analyzed surgical and survival outcomes.
RESULTS
Eight patients underwent 10 intra- and extra-pelvic surgical resections, and their median mass size was 12.75 cm (range, 6-45.5 cm). Using an intrapelvic approach, laparoscopy-assisted surgery was performed in four cases and laparotomy surgery in six. Using an extrapelvic approach, ilioinguinal and posterior approaches were used in four cases each, and the prone position and midline skin incision were shared in one. All patients’ RPS masses were removed completely, and four achieved R0 resection through intra- and extra-pelvic surgery. The median estimated blood loss was 2000 mL (range, 300-20000 mL) and the median hospitalization was 12.6 d (range, 9-69 d). Reoperation was needed in two patients (one for wound necrosis and the other for bowel perforation and wound necrosis). The median overall survival rate and median progression-free survival were 64.6 and 13.7 mo, respectively.
CONCLUSION
RPS is therapeutically challenging because of its location and high risk of recurrence. Therefore, intra- and extra-pelvic surgical approaches can improve the macroscopic security of the surgical margin.
Core Tip: Retroperitoneal sarcomas (RPS) are therapeutically challenging because of their location and high risk of recurrence. Multidisciplinary surgery is an anatomical approach that combines intra- and extra-peritoneal access within the same surgery to achieve complete RPS removal. This retrospective review of the records of eight patients who underwent multidisciplinary surgery for RPS analyzed surgical and survival outcomes. All patients’ RPS masses were removed completely, and four achieved R0 resection through intra- and extra-pelvic surgery. Therefore, intra- and extra-pelvic surgical approaches can improve the macroscopic security of the surgical margin.
