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Leiomyosarcoma of inferior vena cava (IVC): do we really need to reconstruct IVC post resection? Single institution experience

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Abstract

Background

Inferior vena cava (IVC) leiomyosarcomas (LMS) are a rare group of retroperitoneal tumors. R0 surgical resection is the only curative modality of treatment. IVC resection for retroperitoneal sarcoma is a complex surgery with no definitive guidelines for reconstruction.

Methods

Retrospective review of all patients who underwent surgical resection of primary leiomyosarcoma of the IVC requiring resection from 2010 to 2020 at our tertiary care center was performed.

Results

Among 24 patients who required IVC resection for LMS, only 7 (29%) required reconstruction of IVC. According to Clavien-Dindo classification, there was one grade 3 or more morbidity and 1 post-operative mortality. Seventeen patients underwent R0 resection whereas 7 patients had R1 resection on final histopathology. At a median follow-up of 25 months (range 8–91 months), the median OS was 40 months with median DFS of 28 months. Two patients presented with local recurrence while 13 patients developed systemic recurrence on follow-up.

Conclusion

Careful preoperative multidisciplinary planning can make IVC resection without reconstruction feasible with acceptable perioperative morbidity, mortality, and oncological outcomes for IVC LMS.

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Author notes

  1. Mahesh Goel and Anand Mohan have equal contribution as first authors.

Authors and Affiliations

  1. GI & HPB Service, Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Ernest Borges Marg, Parel, Mumbai, 400 012, India

    Mahesh Goel, Anand Mohan & Shraddha Patkar

  2. Department of Interventional Radiology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India

    Kunal Gala, Nitin Shetty & Suyash Kulkarni

  3. Department of Vascular Surgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India

    Jayesh Dhareshwar

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  1. Mahesh Goel
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  2. Anand Mohan
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  4. Kunal Gala
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  6. Suyash Kulkarni
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Correspondence to Shraddha Patkar.

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Name of the institute where study was performed: GI & HPB Service, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India.

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Goel, M., Mohan, A., Patkar, S. et al. Leiomyosarcoma of inferior vena cava (IVC): do we really need to reconstruct IVC post resection? Single institution experience. Langenbecks Arch Surg 407, 1209–1216 (2022). https://doi.org/10.1007/s00423-021-02408-1

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