Email this article Surgical treatment of retroperitoneal liposarcoma using the technology of endoprosthetic replacement of the abdominal aorta and left common iliac artery with an endoprosthesis
- Authors: Stilidi I.S.1, Abgaryan M.G.1, Kalinin A.E.1, Shulumba L.R.1, Egenov O.A.1
-
Affiliations:
- N.N. Blokhin National Medical Research Center of Oncology
- Issue: Vol 9, No 4 (2024)
- Pages: 297-302
- Section: Oncology and radiotherapy
- URL: https://journal-vniispk.ru/2500-1388/article/view/277329
- DOI: https://doi.org/10.35693/SIM642123
- ID: 277329
Cite item
Abstract
Soft tissue sarcomas are rare malignancies, accounting for approximately 1% of all malignancies in adults, with approximately 15–20% of all soft tissue sarcomas arising in the retroperitoneal space. Guidelines for the surgical treatment of retroperitoneal sarcomas are still lacking. Criteria for unresectability remain unclear, and indications and compliance with surgical treatment vary.
A special focus is made on vascular resections in retroperitoneal sarcomas. Surgical intervention with resection of the main vessels in case of their involvement allows for a radical operation and naturally improves long-term results. However, only isolated cases of surgical interventions with resection of the main vessels for retroperitoneal sarcomas are described in the literature.
The article describes a unique clinical case of a two-stage successful surgical treatment of a patient with retroperitoneal liposarcoma and invasion of the aorta and left common iliac artery. At the first stage, an intravascular graft stent was installed. The second stage was en bloc tumor removal, nephrectomy and left hemicolectomy, resection of the infrarenal segment of the abdominal aorta and left common iliac artery.
The discussion provides an analysis of publications on the role of vascular resections in retroperitoneal sarcomas.
The technique of two-stage surgical treatment using endoprosthetics of the main vessel at the first stage, compared to one-stage resection and prosthetics, used in our work has a number of advantages: no need for intraoperative prosthetics of the vessel; no clamping of the abdominal aorta and iliac arteries to form anastomoses; minimal blood loss and reduced surgery time; reduced risk of thrombosis and embolism.
Taking into account the above advantages, this technique can be recommended for retroperitoneal sarcomas with invasion of the main vessels.
Full Text
##article.viewOnOriginalSite##About the authors
Ivan S. Stilidi
N.N. Blokhin National Medical Research Center of Oncology
Email: biochimia@yandex.ru
ORCID iD: 0000-0002-0493-1166
Academician of the Russian Academy of Sciences, Professor, Doctor of Medical Sciences, Director
Russian Federation, MoscowMikael G. Abgaryan
N.N. Blokhin National Medical Research Center of Oncology
Email: abgaryan.mikael@gmail.com
ORCID iD: 0000-0001-8893-1894
PhD, Senior Researcher, Oncologist, Department of Abdominal Oncology No. 1
Russian Federation, MoscowAleksei E. Kalinin
N.N. Blokhin National Medical Research Center of Oncology
Email: main2001@inbox.ru
ORCID iD: 0000-0001-7457-3889
PhD, Senior Researcher, Oncologist, Department of Abdominal Oncology No. 1
Russian Federation, MoscowLola R. Shulumba
N.N. Blokhin National Medical Research Center of Oncology
Email: lolashulu@yandex.ru
ORCID iD: 0009-0001-6360-8932
resident of the Surgical Department No. 1
Russian Federation, MoscowOmar A. Egenov
N.N. Blokhin National Medical Research Center of Oncology
Author for correspondence.
Email: egenov.omar@mail.ru
ORCID iD: 0000-0002-8681-7905
MD, PhD, Oncologist, Department of Abdominal Oncology No. 1
Russian Federation, MoscowReferences
- Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33. DOI: https://doi.org/10.3322/caac.21708
- Porter GA, Baxter NN, Pisters PW. Retroperitoneal sarcoma: a population-based analysis of epidemiology, surgery, and radiotherapy. Cancer. 2006;106(7):1610-6. DOI: https://doi.org/10.1002/cncr.21761
- Dingley B, Fiore M, Gronchi A. Personalizing surgical margins in retroperitoneal sarcomas: an update. Expert Rev Anticancer Ther. 2019;19(7):613-31. DOI: https://doi.org/10.1080/14737140.2019.1625774
- Atakhanova NE, Tursunova NI, Yahyaeva VK. Clinical case of surgical treatment of a malignant tumor from the sheaths of peripheral nerves of retroperitoneal localization. Surgery and Oncology. 2023;13(4):62-7. [Атаханова Н.Э., Турсунова Н.И., Яхяева В.К., и др. Клинический случай хирургического лечения злокачественной опухоли из оболочек периферических нервов забрюшинной локализации. Хирургия и онкология. 2023;13(4):62-7]. DOI: https://doi.org/10.17650/2949-5857-2023-13-4-62-67
- Bonvalot S, Gronchi A, Le Péchoux C, et al. Preoperative radiotherapy plus surgery versus surgery alone for patients with primary retroperitoneal sarcoma (EORTC-62092: STRASS): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2020;21(10):1366-77. DOI: https://doi.org/10.1016/S1470-2045(20)30446-0
- Fairweather M, Gonzalez RJ, Strauss D, Raut CP. Current principles of surgery for retroperitoneal sarcomas. J Surg Oncol. 2018;117(1):33-41. DOI: https://doi.org/10.1002/jso.24919
- Gronchi A, Strauss DC, Miceli R, et al. Variability in patterns of recurrence after resection of primary retroperitoneal sarcoma (RPS): A Report on 1007 Patients From the Multi-institutional Collaborative RPS Working Group. Ann Surg. 2016;263(5):1002-9. DOI: https://doi.org/10.1097/SLA.0000000000001447
- Swallow CJ, Strauss DC, Bonvalot S, et al. Transatlantic Australasian RPS Working Group (TARPSWG). Management of primary retroperitoneal sarcoma (RPS) in the adult: an updated consensus approach from the Transatlantic Australasian RPS Working Group. Ann Surg Oncol. 2021;28(12):7873-88. DOI: https://doi.org/10.1245/s10434-021-09654-z
- Radaelli S, Fiore M, Colombo C, et al. Vascular resection en-bloc with tumor removal and graft reconstruction is safe and effective in soft tissue sarcoma (STS) of the extremities and retroperitoneum. Surg Oncol. 2016;25(3):125-31. DOI: https://doi.org/10.1016/j.suronc.2016.05.002
- Quinones-Baldrich W, Alktaifi A, Eilber F, Eilber F. Inferior vena cava resection and reconstruction for retroperitoneal tumor excision. J Vasc Surg. 2012;55(5):1386-93. DOI: https://doi.org/10.1016/j.jvs.2011.11.054
- Spolverato G, Chiminazzo V, Lorenzoni G, et al. Oncological outcomes after major vascular resections for primary retroperitoneal liposarcoma. Eur J Surg Oncol. 2021;47(12):3004-10. DOI: https://doi.org/10.1016/j.ejso.2021.06.035
- Hu H, Guo Q, Zhao J, et al. Aggressive surgical approach with vascular resection and reconstruction for retroperitoneal sarcomas: a systematic review. BMC Surg. 2023;23(1):275. DOI: https://doi.org/10.1186/s12893-023-02178-1
- Tzanis D, Bouhadiba T, Gaignard E, Bonvalot S. Major vascular resections in retroperitoneal sarcoma. J Surg Oncol. 2018;117(1):42-7. DOI: https://doi.org/10.1002/jso.24920
- Ikoma N, Roland CL, Torres KE, et al. Concomitant organ resection does not improve outcomes in primary retroperitoneal well-differentiated liposarcoma: a retrospective cohort study at a major sarcoma center. J Surg Oncol. 2018;117(6):1188-94. DOI: https://doi.org/10.1002/jso.24951
- Chiappa A, Bertani E, Pravettoni G, et al. Aggressive Surgical Approach for treatment of primary and recurrent retroperitoneal soft tissue sarcoma. Indian J Surg. 2018;80(2):154-62. DOI: https://doi.org/10.1007/s12262-018-1722-7
- Tropea S, Mocellin S, Damiani GB, et al. Recurrent retroperitoneal sarcomas: clinical outcomes of surgical treatment and prognostic factors. Eur J Surg Oncol. 2012;47(5):1201-6. DOI: https://doi.org/10.1016/j.ejso.2020.08.030
- Guo Q, Zhao J, Du X, Huang B. Survival outcomes of surgery for retroperitoneal sarcomas: a systematic review and meta-analysis. PLoS ONE. 2022;17(7):e0272044. DOI: https://doi.org/10.1371/journal.pone.0272044
- Kaganov OI, Kozlov SV, Orlov AE, et al. Single-center experience of surgical treatment of primary retroperitoneal tumors. Indian J Surg Oncol. 2020;11(1):412-7. DOI: https://doi.org/10.1007/s13193-020-01088-5
Supplementary files
