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Morbidity and Outcomes After Distal Pancreatectomy for Primary Retroperitoneal Sarcoma : An Analysis by the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group

Bagaria, Sanjay P. ; Swallow, Carol ; Suraweera, Harini ; Raut, Chandrajit P. ; Fairweather, Mark ; Cananzi, Ferdinando ; Quagliuolo, Vittorio ; Grignani, Giovanni ; Hompes, Daphne and Ford, Samuel J. , et al. (2021) In Annals of Surgical Oncology 28(11). p.6882-6889
Abstract

Background: Multi-visceral resection often is used in the treatment of retroperitoneal sarcoma (RPS). The morbidity after distal pancreatectomy for primary pancreatic cancer is well-documented, but the outcomes after distal pancreatectomy for primary RPS are not. This study aimed to evaluate morbidity and oncologic outcomes after distal pancreatectomy for primary RPS. Methods: In this study, 26 sarcoma centers that are members of the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) retrospectively identified consecutive patients who underwent distal pancreatectomy for primary RPS from 2008 to 2017. The outcomes measured were 90-day severe complications (Clavien-Dindo ≥ 3), postoperative pancreatic fistula... (More)

Background: Multi-visceral resection often is used in the treatment of retroperitoneal sarcoma (RPS). The morbidity after distal pancreatectomy for primary pancreatic cancer is well-documented, but the outcomes after distal pancreatectomy for primary RPS are not. This study aimed to evaluate morbidity and oncologic outcomes after distal pancreatectomy for primary RPS. Methods: In this study, 26 sarcoma centers that are members of the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) retrospectively identified consecutive patients who underwent distal pancreatectomy for primary RPS from 2008 to 2017. The outcomes measured were 90-day severe complications (Clavien-Dindo ≥ 3), postoperative pancreatic fistula (POPF) rate, and oncologic outcomes. Results: Between 2008 and 2017, 280 patients underwent distal pancreatectomy for primary RPS. The median tumor size was 25 cm, and the median number of organs resected, including the pancreas, was three. In 96% of the operations, R0/R1 resection was achieved. The 90-day severe complication rate was 40 %. The grades B and C POPF complication rates were respectively 19% and 5% and not associated with worse overall survival. Administration of preoperative radiation and factors to mitigate POPF did not have an impact on the risk for the development of a POPF. The RPS invaded the pancreas in 38% of the patients, and local recurrence was doubled for the patients who had a microscopic, positive pancreas margin (hazard ratio, 2.0; p = 0.042). Conclusion: Distal pancreatectomy for primary RPS has acceptable morbidity and oncologic outcomes and is a reasonable approach to facilitate complete tumor resection.

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publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Surgical Oncology
volume
28
issue
11
pages
8 pages
publisher
Springer
external identifiers
  • scopus:85101722687
  • pmid:33740198
ISSN
1068-9265
DOI
10.1245/s10434-021-09739-9
language
English
LU publication?
yes
id
34f15773-c42d-4079-821e-be9a14ec8e5b
date added to LUP
2022-03-09 16:28:34
date last changed
2024-06-13 11:22:59
@article{34f15773-c42d-4079-821e-be9a14ec8e5b,
  abstract     = {{<p>Background: Multi-visceral resection often is used in the treatment of retroperitoneal sarcoma (RPS). The morbidity after distal pancreatectomy for primary pancreatic cancer is well-documented, but the outcomes after distal pancreatectomy for primary RPS are not. This study aimed to evaluate morbidity and oncologic outcomes after distal pancreatectomy for primary RPS. Methods: In this study, 26 sarcoma centers that are members of the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) retrospectively identified consecutive patients who underwent distal pancreatectomy for primary RPS from 2008 to 2017. The outcomes measured were 90-day severe complications (Clavien-Dindo ≥ 3), postoperative pancreatic fistula (POPF) rate, and oncologic outcomes. Results: Between 2008 and 2017, 280 patients underwent distal pancreatectomy for primary RPS. The median tumor size was 25 cm, and the median number of organs resected, including the pancreas, was three. In 96% of the operations, R0/R1 resection was achieved. The 90-day severe complication rate was 40 %. The grades B and C POPF complication rates were respectively 19% and 5% and not associated with worse overall survival. Administration of preoperative radiation and factors to mitigate POPF did not have an impact on the risk for the development of a POPF. The RPS invaded the pancreas in 38% of the patients, and local recurrence was doubled for the patients who had a microscopic, positive pancreas margin (hazard ratio, 2.0; p = 0.042). Conclusion: Distal pancreatectomy for primary RPS has acceptable morbidity and oncologic outcomes and is a reasonable approach to facilitate complete tumor resection.</p>}},
  author       = {{Bagaria, Sanjay P. and Swallow, Carol and Suraweera, Harini and Raut, Chandrajit P. and Fairweather, Mark and Cananzi, Ferdinando and Quagliuolo, Vittorio and Grignani, Giovanni and Hompes, Daphne and Ford, Samuel J. and Nessim, Carolyn and Apte, Sameer and Skoczylas, Jacek and Rutkowski, Piotr and Bonvalot, Sylvie and Tzanis, Dimitri and Gabriel, Emmanuel and Pennacchioli, Elisabetta and Albertsmeier, Markus and Canter, Robert J. and Pollock, Raphael and Grignol, Valerie and Cardona, Kenneth and Gamboa, Adriana C. and Novak, Marko and Stoeckle, Eberhard and Almquist, Martin and Ahuja, Nita and Klemen, Nicholas and Van Houdt, Winan and Gyorki, David and Gangi, Alexandra and Rastrelli, Marco and van der Hage, Jos and Schrage, Yvonne and Valeri, Sergio and Conti, Lorenzo and Spiegel, Matthew R. and Li, Zhou and Fiore, Marco and Gronchi, Alessandro}},
  issn         = {{1068-9265}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{6882--6889}},
  publisher    = {{Springer}},
  series       = {{Annals of Surgical Oncology}},
  title        = {{Morbidity and Outcomes After Distal Pancreatectomy for Primary Retroperitoneal Sarcoma : An Analysis by the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group}},
  url          = {{http://dx.doi.org/10.1245/s10434-021-09739-9}},
  doi          = {{10.1245/s10434-021-09739-9}},
  volume       = {{28}},
  year         = {{2021}},
}