Morbidity and Outcomes After Distal Pancreatectomy for Primary Retroperitoneal Sarcoma: An Analysis by the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group

Sanjay P. Bagaria, Carol Swallow, Harini Suraweera, Chandrajit P. Raut, Mark Fairweather, Ferdinando Cananzi, Vittorio Quagliuolo, Giovanni Grignani, Daphne Hompes, Samuel J. Ford, Carolyn Nessim, Sameer Apte, Jacek Skoczylas, Piotr Rutkowski, Sylvie Bonvalot, Dimitri Tzanis, Emmanuel Gabriel, Elisabetta Pennacchioli, Markus Albertsmeier, Robert J. CanterRaphael Pollock, Valerie Grignol, Kenneth Cardona, Adriana C. Gamboa, Marko Novak, Eberhard Stoeckle, Martin Almquist, Nita Ahuja, Nicholas Klemen, Winan Van Houdt, David Gyorki, Alexandra Gangi, Marco Rastrelli, Jos van der Hage, Yvonne Schrage, Sergio Valeri, Lorenzo Conti, Matthew R. Spiegel, Zhou Li, Marco Fiore, Alessandro Gronchi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Multi-visceral resection often is used in the treatment of retroperitoneal sarcoma (RPS). The morbidity after distal pancreatectomy for primary pancreatic cancer is well-documented, but the outcomes after distal pancreatectomy for primary RPS are not. This study aimed to evaluate morbidity and oncologic outcomes after distal pancreatectomy for primary RPS. Methods: In this study, 26 sarcoma centers that are members of the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) retrospectively identified consecutive patients who underwent distal pancreatectomy for primary RPS from 2008 to 2017. The outcomes measured were 90-day severe complications (Clavien-Dindo ≥ 3), postoperative pancreatic fistula (POPF) rate, and oncologic outcomes. Results: Between 2008 and 2017, 280 patients underwent distal pancreatectomy for primary RPS. The median tumor size was 25 cm, and the median number of organs resected, including the pancreas, was three. In 96% of the operations, R0/R1 resection was achieved. The 90-day severe complication rate was 40 %. The grades B and C POPF complication rates were respectively 19% and 5% and not associated with worse overall survival. Administration of preoperative radiation and factors to mitigate POPF did not have an impact on the risk for the development of a POPF. The RPS invaded the pancreas in 38% of the patients, and local recurrence was doubled for the patients who had a microscopic, positive pancreas margin (hazard ratio, 2.0; p = 0.042). Conclusion: Distal pancreatectomy for primary RPS has acceptable morbidity and oncologic outcomes and is a reasonable approach to facilitate complete tumor resection.

Original languageEnglish (US)
JournalAnnals of Surgical Oncology
DOIs
StateAccepted/In press - 2021

ASJC Scopus subject areas

  • Surgery
  • Oncology

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