title: Prosthetic replacement of the infrahepatic inferior vena cava for leiomyosarcoma.
abstract: OBJECTIVE
  Resection of the infrahepatic inferior vena cava associated with prosthetic graft replacement for caval leiomyosarcoma is an acceptable procedure to obtain prolonged and good-quality survival.
  
  
  METHODS
  A consecutive sample clinical study with a mean follow-up of 40 months.
  
  
  METHODS
  The surgical department of an academic tertiary center and an affiliated secondary care center.
  
  
  METHODS
  Eleven patients, with a mean age of 51 years, who have primary leiomyosarcoma of the infrahepatic inferior vena cava.
  
  
  METHODS
  All of the patients underwent radical resection of the tumor en bloc with the affected segment of the vena cava. Reconstruction consisted of 10 cavocaval polytetrafluoroethylene grafts and 1 cavobiliac graft. An associated right nephrectomy was performed in 2 cases. The left renal vein was reimplanted in the graft in 3 cases.
  
  
  METHODS
  Cumulative disease-specific survival, disease-free survival, and graft patency rates expressed by standard life-table analysis.
  
  
  RESULTS
  No patients died in the postoperative period. The cumulative (SE) disease-specific survival rate was 53% (21%) at 5 years. The cumulative (SE) disease-free survival rate was 44% (19%) at 5 years. The cumulative (SE) graft patency rate was 67% (22%) at 5 years.
  
  
  CONCLUSIONS
  Radical resection followed by prosthetic graft reconstruction is a valuable method for treating primary leiomyosarcoma of the infrahepatic inferior vena cava.
authors.affiliation: The Francesco Durante Department of Surgery, University of Rome La Sapienza, Rome, Italy. giulio.illuminati@uniroma1.it
authors.forename: Giulio
authors.initials: G
authors.lastname: Illuminati
authors.forename: Francesco G
authors.initials: FG
authors.lastname: Calio'
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Urso
authors.forename: Daniela
authors.initials: D
authors.lastname: Giacobbi
authors.forename: Vassilios
authors.initials: V
authors.lastname: Papaspyropoulos
authors.forename: Gianluca
authors.initials: G
authors.lastname: Ceccanei
mesh_terms: D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007890:Leiomyosarcoma / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000601:surgery*; D014654:Vascular Patency; D014682:Vena Cava, Inferior / Q000601:surgery*
chemical_list: D011138:Polytetrafluoroethylene