Neoadjuvant radiotherapy and reconstruction using autologous vein graft for the treatment of inferior vena cava leiomyosarcoma.
OBJECTIVE
Inferior vena cava (IVC) leiomyosarcomas are rare and are a relatively small subset of retroperitoneal sarcomas. The current approach is resection and ligation or reconstruction of the IVC. This study was undertaken to analyze the outcomes associated with the use of neoadjuvant radiotherapy and IVC reconstruction in the treatment of IVC leiomyosarcoma.


METHODS
A retrospective clinicopathological review of patients treated during a 10-year period.


RESULTS
Four patients were treated with neoadjuvant radiotherapy, median 47.5 Gy, all underwent margin negative resection with 75% of the tumors being high grade and all patients requiring resection of adjacent organs. Reconstruction of the IVC was performed with an autologous superficial femoral vein graft. There were no mortalities and the morbidity rate was 50%. At a median follow up of 37 months; two patients had a patent IVC, no patients had a local recurrence, and one patient developed a distant metastases treated successfully with metastectomy.


CONCLUSIONS
Neoadjuvant radiotherapy and resection of the IVC leiomyosarcoma resulted in 100% local control, and all patients are alive at median follow up of 37 months. IVC reconstruction with the superficial femoral vein is safe and associated with acceptable short and long term morbidity.
Department of Surgery, Divisions of Surgical Oncology and General Surgery, University of Calgary and the Tom Baker Cancer Centre, Calgary, Alberta, Canada.
Gitonga
G
Munene
Lloyd A
LA
Mack
Randy D
RD
Moore
Walley J
WJ
Temple
D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012186:Retroperitoneal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000601:surgery*