Radical excision for retroperitoneal soft tissue sarcoma: A national propensity-matched outcomes analysis.
Radical excision for retroperitoneal soft tissue sarcoma: A national propensity-matched outcomes analysis.
- 2020
BACKGROUND: Given the rarity of retroperitoneal soft tissue sarcoma, few studies have assessed if radical excision of retroperitoneal soft tissue sarcoma with adjacent organs improves survival outcomes. This propensity score-matched study aimed to evaluate the impact of radical excision versus resection of tumor alone. CONCLUSION: Radical excision was not associated with improved retroperitoneal soft tissue sarcoma survival irrespective of grade, histology, hospital volume, or adjacent organ involvement. Resection of ostensibly involved adjacent viscera may increase morbidity without survival benefit. These results inform ongoing discussion regarding histology-tailored, situation-specific extent of retroperitoneal soft tissue sarcoma resections. Copyright (c) 2020. Published by Elsevier Inc. METHODS: The National Cancer Database 2004 to 2015 was used to assess short- and long-term outcomes of resection of tumor alone versus radical excision (tumor plus >=1 adjacent organs) via 1:1 propensity-matched analyses. Subgroup analyses included low-grade, high-grade, liposarcoma, leiomyosarcoma, adjacent organ involvement alone, localized tumors alone, and high-volume hospitals (>=10 resections/y). Multivariable logistic regression models identified factors associated with radical excision. RESULTS: Comparison of propensity-matched groups (N = 1,139/group) revealed no significant differences in 30-day mortality, 90-day mortality, or overall survival (for all, P > .580). For all subgroup analyses comparing resection of tumor alone with radical excision, including localized tumors without organ invasion (N = 208/group), there were no identified differences in short- or long-term survival. Although it yielded lower R2 resection rates (P = .007), radical excision was associated with greater mean length of stay (P < .001).
English
0039-6060
10.1016/j.surg.2020.05.031 [doi] S0039-6060(20)30330-5 [pii]
*Propensity Score
*Retroperitoneal Neoplasms/su [Surgery]
*Sarcoma/su [Surgery]
Adult
Aged
Female
Humans
Logistic Models
Male
Middle Aged
Retroperitoneal Neoplasms/mo [Mortality]
Retroperitoneal Neoplasms/pa [Pathology]
Sarcoma/mo [Mortality]
Sarcoma/pa [Pathology]
MedStar Health Research Institute
MedStar Washington Hospital Center
Surgery/General Surgery
Journal Article
BACKGROUND: Given the rarity of retroperitoneal soft tissue sarcoma, few studies have assessed if radical excision of retroperitoneal soft tissue sarcoma with adjacent organs improves survival outcomes. This propensity score-matched study aimed to evaluate the impact of radical excision versus resection of tumor alone. CONCLUSION: Radical excision was not associated with improved retroperitoneal soft tissue sarcoma survival irrespective of grade, histology, hospital volume, or adjacent organ involvement. Resection of ostensibly involved adjacent viscera may increase morbidity without survival benefit. These results inform ongoing discussion regarding histology-tailored, situation-specific extent of retroperitoneal soft tissue sarcoma resections. Copyright (c) 2020. Published by Elsevier Inc. METHODS: The National Cancer Database 2004 to 2015 was used to assess short- and long-term outcomes of resection of tumor alone versus radical excision (tumor plus >=1 adjacent organs) via 1:1 propensity-matched analyses. Subgroup analyses included low-grade, high-grade, liposarcoma, leiomyosarcoma, adjacent organ involvement alone, localized tumors alone, and high-volume hospitals (>=10 resections/y). Multivariable logistic regression models identified factors associated with radical excision. RESULTS: Comparison of propensity-matched groups (N = 1,139/group) revealed no significant differences in 30-day mortality, 90-day mortality, or overall survival (for all, P > .580). For all subgroup analyses comparing resection of tumor alone with radical excision, including localized tumors without organ invasion (N = 208/group), there were no identified differences in short- or long-term survival. Although it yielded lower R2 resection rates (P = .007), radical excision was associated with greater mean length of stay (P < .001).
English
0039-6060
10.1016/j.surg.2020.05.031 [doi] S0039-6060(20)30330-5 [pii]
*Propensity Score
*Retroperitoneal Neoplasms/su [Surgery]
*Sarcoma/su [Surgery]
Adult
Aged
Female
Humans
Logistic Models
Male
Middle Aged
Retroperitoneal Neoplasms/mo [Mortality]
Retroperitoneal Neoplasms/pa [Pathology]
Sarcoma/mo [Mortality]
Sarcoma/pa [Pathology]
MedStar Health Research Institute
MedStar Washington Hospital Center
Surgery/General Surgery
Journal Article