Inferior Vena Cava Leiomyosarcoma: What Method of Reconstruction for Which Type of Resection?

Inferior vena cava leiomyosarcoma (IVCL) is a rare tumor with a poor prognosis, and its surgical resection remains a challenge. To date, surgery is the only potentially curative treatment for IVCL with a 5-year survival rate of 55%. The main challenge is to combine oncological surgery with clear mar...

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Bibliographic Details
Published in:World journal of surgery 2020-10, Vol.44 (10), p.3537-3544
Main Authors: Gaignard, Elodie, Bergeat, Damien, Robin, Fabien, Corbière, Lisa, Rayar, Michel, Meunier, Bernard
Format: Article
Language:English
Subjects:
Abdominal Surgery
Autografts
Cardiac Surgery
General Surgery
Humans
Leiomyosarcoma - pathology
Leiomyosarcoma - surgery
Life Sciences
Medical prognosis
Medicine
Medicine & Public Health
Patient Care Team
Prostheses
Reconstructive Surgical Procedures - methods
Sarcoma
Scientific Review
Surgery
Survival
Thoracic Surgery
Tumors
Vascular Neoplasms - pathology
Vascular Neoplasms - surgery
Vascular Surgery
Vena Cava, Inferior - pathology
Vena Cava, Inferior - surgery
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Summary:Inferior vena cava leiomyosarcoma (IVCL) is a rare tumor with a poor prognosis, and its surgical resection remains a challenge. To date, surgery is the only potentially curative treatment for IVCL with a 5-year survival rate of 55%. The main challenge is to combine oncological surgery with clear margins and vascular reconstruction of the inferior vena cava (IVC). In this review, we discuss the different approaches to vascular reconstruction after IVCL resection, using a prosthetic or autologous patch, direct suture or simple ligation without IVC reconstruction. The reconstruction of IVC depends of tumor location and its extension. We recommend no reconstruction if venous collaterality is well-established. When vascular reconstruction is required, we prefer prosthetic PTFE graft. These patients should be referred to high-volume centers with a multidisciplinary team of sarcoma surgeons with cardiothoracic, vascular and hepatic specialties.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-020-05602-2