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01-08-2018 | Bone and Soft Tissue Sarcomas

Minimally Invasive Versus Open Primary Resection for Retroperitoneal Soft Tissue Sarcoma: A Propensity-Matched Study From the National Cancer Database

Authors: Faiz Gani, MBBS, Utkarsh Goel, Alex B. Blair, MD, Jasvinder Singh, MD, Heidi N. Overton, MD, Christian F. Meyer, MD, MS, PhD, Joseph K. Canner, MHS, Timothy M. Pawlik, MD, MPH, PhD, Nita Ahuja, MD, MBA, Fabian M. Johnston, MD, MHS, FACS

Published in: Annals of Surgical Oncology | Issue 8/2018

Abstract

Background

Although well described for gastrointestinal and pelvic cancers, use of minimally invasive surgery (MIS) for the management of retroperitoneal soft tissue sarcoma (RPS) remains unknown. The current study aimed to describe patterns of MIS use and assess the association between MIS and clinical outcomes among patients undergoing surgery for RPS.

Methods

Patients undergoing a primary resection for RPS between 2010 and 2014 were identified using the National Cancer Database. Multivariable logistic and Cox proportional hazards models were used to assess the association between use of MIS and clinical outcomes. Sensitivity analysis was performed using propensity score-matching (PSM).

Results

This study identified 3844 patients who met the inclusion criteria. Of these patients, 89.3% (n = 3432) underwent an open surgery, whereas 10.7% (n = 412) underwent MIS. The patients undergoing MIS were more likely to present with smaller tumors (open vs MIS: median tumor size, 17 cm; interquartile range [IQR, 9.8–26.0] vs 10.5 cm [IQR, 6.5–18.0]) and to undergo surgery at community hospitals (26.8% vs 36.1%; both P < 0.001). Although MIS was associated with a shorter hospital length of stay [LOS] (median LOS, 6 days [IQR, 5–9 days] vs 4 days [IQR, 2–7]; P < 0.001), postoperative mortality and overall survival were comparable between the two treatment groups (all P > 0.05). These findings were confirmed using PSM.

Conclusions

MIS was associated with a shorter LOS, however, postoperative mortality and overall survival were comparable by operative approach. Future research is required to evaluate the use of MIS for the management of RPS. Policies are required to ensure that patients receive care in accordance with best practices and recommended guidelines.

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Title: Minimally Invasive Versus Open Primary Resection for Retroperitoneal Soft Tissue Sarcoma: A Propensity-Matched Study From the National Cancer Database
Authors: Faiz Gani, MBBS
Utkarsh Goel
Alex B. Blair, MD
Jasvinder Singh, MD
Heidi N. Overton, MD
Christian F. Meyer, MD, MS, PhD
Joseph K. Canner, MHS
Timothy M. Pawlik, MD, MPH, PhD
Nita Ahuja, MD, MBA
Fabian M. Johnston, MD, MHS, FACS
Publication date: 01-08-2018
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 8/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-018-6538-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Minimally Invasive Versus Open Primary Resection for Retroperitoneal Soft Tissue Sarcoma: A Propensity-Matched Study From the National Cancer Database

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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