Intra and extra pelvic multidisciplinary surgical approach of retroperitoneal sarcoma: Case series report

Table 1 Characteristics of patients with retroperitoneal sarcoma (n = 8)

Characteristics	Value
Mean age (yr)	42.75 ± 18.4
Mean BMI	22.4 ± 2.4
Initial symptoms, n (%)
Palpable mass	4 (50)
Pain on the specific site	4 (50)
Median mass size (long axis, cm)	12.75 ± 11.7
Order of surgery, n (%)
Primary	3 (30)
Secondary	2 (20)
Tertiary	2 (20)
More than tertiary	3 (30)
History of neoadjuvant or adjuvant treatment, n (%)
Neoadjuvant treatment	2 (25)
Adjuvant treatment	8 (100)
Surgical outcome
Median overall survival (mo, median)	64.6
Progression-free survival (mo, median)	13.7
Died patients due to disease, n (%)	2 (25)
Pathology, n (%)
Liposarcoma	2 (25)
Leiomyosarcoma	1 (12.5)
Malignant peripheral nerve sheath tumor	1 (12.5)
Osteosarcoma	2 (25)
Chondrosarcoma	1 (12.5)
Low-grade fibromyxoid sarcoma	1 (12.5)

Table 2 Surgical approach and outcomes (total 10 cases)

PN	Number of surgery	Intra pelvic surgery	Extra pelvic surgery	Pathology	Resection margin		EBL (mL)	HD (d)	OS (mo)	PFS (mo)
		Approach method and operation title	Approach method and operation title		Intra pelvic surgery	Extra pelvic surgery
1	Primary surgery	Laparoscopy	Posterior approach of hip	WDLPS	R0	R0	300	15	65.3	13.7
		Mass excision	Wide excision
1	Secondary surgery	Laparotomy	Laparotomy	WDLPS	R1	R1	2000	17	65.3	50
		Mass excision	Marginal excisionneurolysis
		Dissection and mobilization of Lt. internal iliac vessel
		Ligation of Lt. iliac vein
2	5th surgery	Laparotomy	Ilioinguinal approach	LMS	R1	R0	1250	19	97	9
		Mass excision	Wide excision
3	Secondary surgery	Laparoscopy	Ilioinguinal approach	MPNST	R0	R1	10000	42	63.9	4.3
		Rt. RSO and PLND	Wide excision
		Sigmoid colon mobilization
		Dissection of Rt. external and internal iliac vessel
4	Primary surgery	Laparotomy	Posterior approach of hip	Myxoid liposarcoma	R0	R1	2000	16	55.7	49
		Mass excision	Wide excision neurolysis
		Dissection of Lt. common and external iliac vessel
		Ligation of Lt. internal iliac artery
5	Tertiary surgery	Laparotomy	Posterior approach of hip	Osteosarcoma	R0	R0	20000	52	52	11.5
		Mass excision	Wide excision, neurotomy L5-S1
		Rectum mobilization
6	Tertiary surgery	Laparotomy	Ilioinguinal approach	LGFMS	R1	R0	12000	67	206.8	28.9
		Mass excision	Marginal excision skin flap and graft
		Int. iliac-deep femoral artery, allograft bypass
		Rt. D-J catheter insertion with primary bladder repair
6	Quaternary surgery	Laparotomy	Prone position	Osteosarcoma	R1	R0	700	12	206.8	14.6
		Mass excision	Wide excision
7	Primary surgery	Laparoscopy	Posterior approach of hip	Malignant spindle cell tumor	R0	R0	10000	69	11.4	7.5
		Mass excision	Wide excision neurolysis L5-S3, Lt.
		Dissection and mobilization of Lt. external and internal iliac vessel
8	5th surgery	Laparoscopy	Ilioinguinal approach	Chondrosarcoma	R0	R0	300	9	115	13.7
		Mass excision, Rt. PLND	Marginal excision
		Primary closure of Rt. external iliac vein

EBL: Estimated blood loss; HD: Hospitalization days; LGFMS: Low-grade fibromyxoid sarcoma; LMS: Leiomyosarcoma; MPNST: Malignant peripheral nerve sheath tumor; OS: Overall survival; PFS: Progression-free survival; PN: Patient number; RSO: Right salpingo-oophorectomy; WDLPS: Well-differentiated liposarcoma; PLND: Pelvic lymph node dissection.