Area of combined surgical interventions, including those with an angiosurgical component, in terms of malignant non-organ retroperitoneal tumors’ treatment

Purpose of the study. To analyze the immediate outcomes following surgical treatment of locally advanced malignant non-organ retroperitoneal tumors (NRT).

Materials and methods. Surgical interventions for malignant NRTs were performed in 114 patients at Abdominal Oncology Department № 1, National Medical Research Centre for Oncology.There were 48 males and 66 females among them. According to the histological structure, liposarcoma was commonly detected in 64 (56.1 %) cases.

Results. Intraoperative revision revealed the spread of the tumor to adjacent anatomical structures in 67 (58.8 %) cases. Resection surgical interventions were performed in 109 patients, of which 106 (97.2 %) patients had operations performed in an amount of R0. Combined surgical interventions for NRTs were performed in 62 (54.4 %) patients, and multiorgan happened to be in 45 (72.6 %) patients out of those. Resection of the inferior vena cava was performed in 12 patients. Resection of the superior mesenteric vein was performed in 2 patients and the iliac-colonic vein in 2 patients. In 1 observation the left renal vein was resected with suturing of the lateral defect of the vessel wall. Complications during surgery and in the early postoperative period were noted in 14 (12.3 %) patients. In total, 2 patients died after operations, the mortality rate was 1.8 %.

Conclusions. Tumor invasion of big main blood vessels is not a contraindication for surgical treatment of locally spread malignant non-organ retroperitoneal tumors.

1. Rasulov RI, Dvornichenko VV, Muratov AA, Songolov GI, Mozgunov DV. Primary retroperitoneal tumors: past and present (the literature review). Siberian Medical Journal. 2015;7:5–14. (In Russ.). EDN: VZGEUD

2. Gronchi A, Strauss DC, Miceli R, Bonvalot S, Swallow CJ, Hohenberger P, et al. Variability in Patterns of Recurrence After Resection of Primary Retroperitoneal Sarcoma (RPS): A Report on 1007 Patients From the Multi-institutional Collaborative RPS Working Group. Ann Surg. 2016 May;263(5):1002–1009. https://doi.org/10.1097/SLA.0000000000001447

3. Gamboa AC, Ethun CG, Switchenko JM, Lipscomb J, Poultsides GA, Grignol V, et al. Lung Surveillance Strategy for High-Grade Soft Tissue Sarcomas: Chest X-Ray or CT Scan? J Am Coll Surg. 2019 Nov;229(5):449–457. https://doi.org/10.1016/j.jamcollsurg.2019.07.010

4. Tseng WW, Wang SC, Eichler CM, Warren RS, Nakakura EK. Complete and safe resection of challenging retroperitoneal tumors: anticipation of multi-organ and major vascular resection and use of adjunct procedures. World J Surg Oncol. 2011 Nov 4;9:143. https://doi.org/10.1186/1477-7819-9-143

5. Kit OI, Kasatkin VF, Maksimov AYu Moroshan AN. Surgical treatment of non-organ retroperitoneal tumors. Palliative Medicine and Rehabilitation. 2012;1:27–29. (In Russ.). EDN: NJILFO

6. Kaprin AD, Ryabov AB, Khomyakov VM, Cheremisov VV, Khoronenko VE, Chissov VI, et al. Resection of the inferior vena cava in locally advanced non-organ retroperitoneal tumors. Oncology. P. A. Herzen Journal. 2017;6(1):28–38. (In Russ.). https://doi.org/10.17116/onkolog20176128-38, EDN: XXKWYR

7. Stilidi IS, Abgarian MG, Nikulin MP, Kalinin AE. Iliac arteries and aortic repair in patients with retroperitoneal sarcoma. Surgery. Journal named after N. I. Pirogov. 2017;(5):14–22. (In Russ.). https://doi.org/10.17116/hirurgia2017514-22, EDN: WDKRLE

8. Tereshin OS, Zotov SP, Zaikov AA. Surgical excision of retroperitoneal tumors involving great vessels. Oncosurgery. 2013;5(4):8–14. (In Russ.). EDN: RVOIHR

9. Quinones-Baldrich W, Alktaifi A, Eilber F, Eilber F. Inferior vena cava resection and reconstruction for retroperitoneal tumor excision. J Vasc Surg. 2012 May;55(5):1386–1393. https://doi.org/10.1016/j.jvs.2011.11.054

10. Song TK, Harris EJ, Raghavan S, Norton JA. Major blood vessel reconstruction during sarcoma surgery. Arch Surg. 2009 Sep;144(9):817–822. https://doi.org/10.1001/archsurg.2009.149