Neoadjuvant radiotherapy and reconstruction using autologous vein graft for the treatment of inferior vena cava leiomyosarcoma

Background and Objectives Inferior vena cava (IVC) leiomyosarcomas are rare and are a relatively small subset of retroperitoneal sarcomas. The current approach is resection and ligation or reconstruction of the IVC. This study was undertaken to analyze the outcomes associated with the use of neoadju...

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Bibliographic Details
Published in:Journal of surgical oncology 2011-02, Vol.103 (2), p.175-178
Main Authors: Munene, Gitonga, Mack, Lloyd A., Moore, Randy D., Temple, Walley J.
Format: Article
Language:English
Subjects:
Female
Humans
Leiomyosarcoma - radiotherapy
Leiomyosarcoma - surgery
Male
Middle Aged
neodjuvant radiotherapy
Radiotherapy, Adjuvant
Retroperitoneal Neoplasms - radiotherapy
Retroperitoneal Neoplasms - surgery
retroperitoneal sarcoma
Retrospective Studies
surgery
Treatment Outcome
Vascular Neoplasms - radiotherapy
Vascular Neoplasms - surgery
Vena Cava, Inferior - surgery
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Summary:Background and Objectives Inferior vena cava (IVC) leiomyosarcomas are rare and are a relatively small subset of retroperitoneal sarcomas. The current approach is resection and ligation or reconstruction of the IVC. This study was undertaken to analyze the outcomes associated with the use of neoadjuvant radiotherapy and IVC reconstruction in the treatment of IVC leiomyosarcoma. Methods A retrospective clinicopathological review of patients treated during a 10‐year period. Results Four patients were treated with neoadjuvant radiotherapy, median 47.5 Gy, all underwent margin negative resection with 75% of the tumors being high grade and all patients requiring resection of adjacent organs. Reconstruction of the IVC was performed with an autologous superficial femoral vein graft. There were no mortalities and the morbidity rate was 50%. At a median follow up of 37 months; two patients had a patent IVC, no patients had a local recurrence, and one patient developed a distant metastases treated successfully with metastectomy. Conclusions Neoadjuvant radiotherapy and resection of the IVC leiomyosarcoma resulted in 100% local control, and all patients are alive at median follow up of 37 months. IVC reconstruction with the superficial femoral vein is safe and associated with acceptable short and long term morbidity. J. Surg. Oncol. 2011; 103:175–178. © 2010 Wiley‐Liss, Inc.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.21798