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Outcomes of palliative‐intent surgery in retroperitoneal sarcoma—Results from the US Sarcoma Collaborative
Author(s) -
Thalji Sam Z.,
Tsai Susan,
Gamblin T. Clark,
Clarke Callisia,
Christians Kathleen,
Charlson John,
Ethun Cecilia G.,
Poultsides George,
Grignol Valerie P.,
Roggin Kevin K.,
Votanopoulos Konstantinos,
Fields Ryan C.,
Abbott Daniel E.,
Cardona Kenneth,
Mogal Harveshp
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25890
Subject(s) - medicine , liposarcoma , leiomyosarcoma , sarcoma , incidence (geometry) , palliative care , logistic regression , surgery , proportional hazards model , overall survival , retrospective cohort study , pathology , nursing , physics , optics
Background and Objectives Outcomes of palliative‐intent surgery in retroperitoneal sarcomas (RPS) are not well understood. This study aims to define indications for and outcomes after palliative‐intent RPS resection. Methods Using a retrospective 8‐institution database, patients undergoing resection of primary/recurrent RPS with palliative intent were identified. Logistic regression and Cox‐proportional hazards models were constructed to analyze factors associated with postoperative complications and overall survival (OS). Results Of 3088 patients, 70 underwent 87 palliative‐intent procedures. Most common indications were pain (26%) and bowel obstruction (21%). Dedifferentiated liposarcoma (n = 17, 24%), leiomyosarcoma (n = 13, 19%) were predominant subtypes. Median OS was 10.69 months (IQR, 3.91‐23.23). R2 resection (OR, 8.60; CI, 1.42‐52.15; P = .019), larger tumors (OR, 10.87; CI, 1.44‐82.11; P = .021) and low preoperative albumin (OR, 0.14; CI, 0.04‐0.57; P = .006) were associated with postoperative complications. Postoperative complications (HR, 1.95; CI, 1.02‐3.71; P = .043) and high‐grade histology (HR, 6.56; CI, 1.72‐25.05; P = .006) rather than resection status were associated with reduced OS. However, in R2‐resected patients, development of postoperative complications significantly reduced survival ( P = .042). Conclusions Postoperative complications and high‐grade histology rather than resection status impacts survival in palliative‐intent RPS resections. Given the higher incidence of postoperative complications which may diminish survival, palliative‐intent R2 resection should be offered only after cautious consideration.