Surgical treatment and outcomes of patients with primary inferior vena cava leiomyosarcoma Journal Article


Authors: Hollenbeck, S. T.; Grobmyer, S. R.; Kent, K C.; Brennan, M. F.
Article Title: Surgical treatment and outcomes of patients with primary inferior vena cava leiomyosarcoma
Abstract: BACKGROUND: The inferior vena cava (IVC) is a rare site for primary soft tissue sarcoma. There are limited data in the literature regarding surgical management of the IVC and longterm survival of these patients. STUDY DESIGN: From 1982 to 2002, a total of 25 patients with primary IVC leiomyosarcoma was treated as inpatients and followed in a prospective database at Memorial Sloan-Kettering. Presenting symptoms, tumor characteristics, operative management, postoperative morbidity, and disease-specific survival were assessed for each patient. RESULTS: The 25 patients with primary IVC leiomyosarcoma accounted for 0.5% of all adult patients with soft tissue sarcoma treated during this time. The median patient age was 56 years (range 41 to 79 years). The three most common presenting symptoms were abdominal pain (52%), distention (20%), and deep venous thrombosis (12%). Of the patients, 21 (84%) underwent complete resection of the tumor. The IVC was managed in one of three ways: ligation (n = 11), primary/patch repair (n = 8), and expanded polytetrafluoroethylene tube grafting (n = 2). Among patients undergoing IVC ligation and primary/patch repair (n = 19), 11% had severe postoperative edema and none had worsening renal function. Local recurrence occurred in 33% of patients and distant recurrence occurred in 48% of patients. Patients undergoing complete resection had 3-year and 5-year disease-specific survival rates of 76% and 33%, respectively. There were no 3-year survivors among patients with incomplete resections. CONCLUSIONS: Complete resection of primary IVC leiomyosarcomas is feasible and associated with improved survival. The IVC can be managed by primary repair or ligation with a low risk of severe postoperative edema. © 2003 by the American College of Surgeons.
Keywords: adult; cancer survival; clinical article; controlled study; treatment outcome; aged; middle aged; cancer surgery; cancer recurrence; vascular neoplasms; edema; neoplasm recurrence, local; deep vein thrombosis; abdominal pain; postoperative complication; survival time; symptom; kidney function; soft tissue sarcoma; leiomyosarcoma; inferior cava vein; politef; abdominal distension; vena cava, inferior; kidney dysfunction; vein ligation; vein graft; humans; human; male; female; priority journal; article; primary inferior vena cava leiomyosarcoma; vein reconstruction
Journal Title: Journal of the American College of Surgeons
Volume: 197
Issue: 4
ISSN: 1072-7515
Publisher: Elsevier Science, Inc.  
Date Published: 2003-10-01
Start Page: 575
End Page: 579
Language: English
DOI: 10.1016/s1072-7515(03)00433-2
PUBMED: 14522326
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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  1. Murray F Brennan
    1059 Brennan