title: Oncovascular compartmental resection for retroperitoneal soft tissue sarcoma with vascular involvement.
abstract: This study analyzed the outcomes of a series of consecutive patients diagnosed with a retroperitoneal soft tissue sarcoma (RSTS) with vascular involvement and who underwent a multidisciplinary operation.
  
  
  
  Between 2000 and 2013, 126 patients were referred for oncovascular surgery in our institution. Among these, 31 consecutive patients underwent operations for RSTS with vascular involvement. A vascular/oncologic team determined the surgical strategy preoperatively.
  
  
  
  Median follow-up was 34.4 months (interquartile range, 48.1 months). Twenty patients (65%) were referred for primary RSTS and 11 (35%) for local recurrence. The most common histologic diagnosis was liposarcoma (54.8%), mainly high-grade and intermediate-grade RSTS. Prosthetic grafts were usually used for vascular reconstruction. Median hospital stay was 17 days (interquartile range, 14.5; range, 7-190 days). The grade 3 and 4 morbidity rate was 19.3%. Each resection was macroscopically complete (R0-R1). Median progression-free survival was 10 months, and median overall survival was not reached. Overall survival rates were 77.4% at 1 year and 61.3% at 3 years.
  
  
  
  Vascular resection and reconstruction are safe and feasible in case of RSTS. The morbidity rate was acceptable, and there were no perioperative deaths. Despite recurrence rates that remain high, oncovascular resection enhances resection margins and allows encouraging survival results for patients often considered as nonresectable.
authors.affiliation: Surgical Oncology Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France.
authors.forename: Martin Marie
authors.initials: MM
authors.lastname: Bertrand
authors.affiliation: Surgical Oncology Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Carrère
authors.affiliation: Surgical Oncology Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Delmond
authors.affiliation: Surgical Oncology Department, Saifee Hospital, Mumbai, Maharashtra, India.
authors.forename: Sanket
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Surgical Oncology Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Rouanet
authors.affiliation: Department of Vascular and Thoracic Surgery, Hôpital Arnaud de Villeneuve, Montpellier, France.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Canaud
authors.affiliation: Surgical Oncology Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France; Surgical Oncology Department, Saifee Hospital, Mumbai, Maharashtra, India.
authors.forename: Pierre
authors.initials: P
authors.lastname: Alric
authors.affiliation: Surgical Oncology Department, Institut régional du Cancer de Montpellier (ICM), Montpellier, France. Electronic address: francois.quenet@icm.unicancer.fr.
authors.forename: François
authors.initials: F
authors.lastname: Quénet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000401:mortality; D000072226:Computed Tomography Angiography; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014680:Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*