Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 21, 2022; 10(3): 811-819
Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.811
Management of retroperitoneal sarcoma involving the iliac artery: Single-center surgical experience
Wen-Xiang Li, Han-Xing Tong, Chen-Tao Lv, Hua Yang, Gang Zhao, Wei-Qi Lu, Yong Zhang
Wen-Xiang Li, Chen-Tao Lv, Hua Yang, Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai 200083, China
Han-Xing Tong, Gang Zhao, Wei-Qi Lu, Yong Zhang, Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Author contributions: Li WX and Tong HX collected the data and performed statistical analyses; Lv CT and Yang H prepared the figures and tables; Li WX wrote the paper; Zhang Y, Zhao G, and Lu WQ were responsible for designing the study, critically reviewed the article, and approved the final version of the article to be published.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Zhongshan Hospital, Fudan University.
Informed consent statement: Written informed consent for inclusion in our database was obtained from all patients.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong Zhang, PhD, Chief Doctor, Department of General Surgery, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai 200032, China. 13681971072@163.com
Received: June 9, 2021
Peer-review started: June 9, 2021
First decision: June 25, 2021
Revised: September 15, 2021
Accepted: December 22, 2021
Article in press: December 22, 2021
Published online: January 21, 2022
Abstract
BACKGROUND

Management of retroperitoneal sarcoma (RPS) involving the iliac artery is challenging and requires the concerted efforts of multidisciplinary team (MDT) members during surgical treatment.

AIM

To summarize the clinicopathologic features of RPS involving the iliac artery and our retroperitoneal soft tissue tumor MDT surgical experience.

METHODS

In this retrospective study, 15 patients with RPS involving the iliac artery who underwent surgery at our retroperitoneal soft tissue tumor center from July 2004 to June 2020 were analyzed. Statistical analyses were performed by Student’s t-test with SPSS 16.0.

RESULTS

Complete tumor resection (R0/R1) and iliac artery reconstruction were achieved in all 15 patients. All the operations were successful, with no serious complications or perioperative death. Resection with bilateral iliac artery reconstruction required a higher intraoperative blood transfusion volume than resection with unilateral iliac artery reconstruction. Recurrent cases were more likely to bleed and required a higher blood transfusion volume than primary cases. As of January 2021, 11 patients were alive, and 4 had died. Local recurrence occurred in two patients, one of whom developed liver metastasis.

CONCLUSION

Resection of RPS involving iliac vessels is feasible and effective when performed by MDT members. Iliac artery oncovascular resection and reconstruction are key to a successful operation. Adequate blood preparation is important for successful completion of surgery.

Keywords: Retroperitoneal sarcoma, Vascular reconstruction, Multidisciplinary team, Iliac artery, Blood transfusion

Core Tip: This is a retrospective study of retroperitoneal sarcoma involving the iliac artery. Fifteen patients underwent tumor resection (R0/R1) and iliac artery reconstruction from July 2004 to June 2020. Eleven patients were alive and four had died as of January 2021. Local recurrence occurred in two patients, one of whom developed liver metastasis. Resection with bilateral iliac artery reconstruction required a higher intraoperative blood transfusion volume than resection with unilateral iliac artery reconstruction. Oncovascular resection of the involved iliac artery and vessel reconstruction are pivotal for complete tumor resection. Adequate blood preparation is important to ensure surgical success.