title: Outcomes Following Extended Surgery for Retroperitoneal Sarcomas: Results From a UK Referral Centre.
abstract: BACKGROUND
  Primary extended resection has been proposed as the initial treatment for patients with retroperitoneal sarcoma. This approach comprises an extended en-bloc resection of the directly infiltrated organs and adjacent uninvolved organs. The results of such radical surgery have yet to be validated. This retrospective study aims to investigate this practice in a contemporary series from a referral center in the UK.
  
  
  METHODS
  We extracted data from consecutive patients who underwent extended resectional surgery between 2009 and 2013, and investigated the type of resection performed, the effectiveness of extended surgery in providing negative microscopic margins, and the occurrence of post-surgical adverse events.
  
  
  RESULTS
  A total of 69 patients were included. Fifty-two patients had a primary tumor (75.4 %), and in 55 patients (79.7 %) the tumor was resected en bloc with adjacent organs or structures. Colonic resection (N = 35, 50.7 %) and nephrectomy (N = 28, 40.6 %) were the most frequently performed organ resections. Organs were infiltrated in 22 patients (32 %), and there was no association between organ infiltration and patient variables and staging characteristics. Negative microscopic margins were achieved in 88.6 % of patients in this series. Postoperative complications occurred in 21 patients (30 %) and a reoperation was required in ten cases (14.5 %). No independent predictors of morbidity were identified and no 30-day postoperative deaths occurred.
  
  
  CONCLUSIONS
  Four-fifths of patients in this series had organs removed in association with the retroperitoneal sarcoma. This approach in a specialist sarcoma unit results in negative microscopic tumor margins in up to 90 % of cases and can be performed safely.
authors: Midlands Abdominal and Retroperitoneal Sarcoma Unit, The Queen Elizabeth Hospital Birmingham, Birmingham, UK.
authors: Sandro
authors: S
authors: Pasquali
authors: Midlands Abdominal and Retroperitoneal Sarcoma Unit, The Queen Elizabeth Hospital Birmingham, Birmingham, UK.|Academic Department of Surgery, University of Birmingham, Birmingham, UK.
authors: Ravinder
authors: R
authors: Vohra
authors: Academic Department of Psychology, University of Birmingham, Birmingham, UK.
authors: Ioanna
authors: I
authors: Tsimopoulou
authors: Midlands Abdominal and Retroperitoneal Sarcoma Unit, The Queen Elizabeth Hospital Birmingham, Birmingham, UK.
authors: Deepak
authors: D
authors: Vijayan
authors: Midlands Abdominal and Retroperitoneal Sarcoma Unit, The Queen Elizabeth Hospital Birmingham, Birmingham, UK.
authors: David
authors: D
authors: Gourevitch
authors: Midlands Abdominal and Retroperitoneal Sarcoma Unit, The Queen Elizabeth Hospital Birmingham, Birmingham, UK. anant.desai@uhb.nhs.uk.
authors: Anant
authors: A
authors: Desai
mesh_terms: D000315:Adrenalectomy / Q000009:adverse effects; D000368:Aged; D002173:Cancer Care Facilities; D003082:Colectomy / Q000009:adverse effects; D015653:Cystectomy / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D007421:Intestine, Small / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual; D009392:Nephrectomy / Q000009:adverse effects; D010052:Ovariectomy / Q000009:adverse effects; D010180:Pancreatectomy / Q000009:adverse effects; D012086:Reoperation; D012186:Retroperitoneal Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D058994:Salpingectomy / Q000009:adverse effects; D012509:Sarcoma / Q000473:pathology* / Q000601:surgery*; D013156:Splenectomy / Q000009:adverse effects; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D015996:Survival Rate; D016896:Treatment Outcome; D006113:United Kingdom; D014513:Ureter / Q000601:surgery