Li Yiyuan, Zhao Jichun, Huang Bin, Du Xiaojiong, Hu Hankui, Guo Qiang
Division of Vascular Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu , Sichuan Province, China.
PLoS One. 2025 Mar 20;20(3):e0320066. doi: 10.1371/journal.pone.0320066. eCollection 2025.
En bloc resection of adjacent structures, including major vessels, is often required to achieve negative margins in retroperitoneal sarcoma (RPS). However, the effect of vascular involvement and different reconstruction techniques in patients undergoing vascular resection remains unclear. This study investigated the morbidity, mortality, and long-term survival of patients who underwent an aggressive surgical approach with vascular resection for RPS.
We analyzed a prospectively maintained database of patients who underwent surgical resection (with or without vascular resection) for RPS between 2015 and 2020. The primary endpoint was long-term overall survival (OS).
The study population comprised 252 patients. Postoperative morbidity, mortality, and OS did not differ significantly between the vascular and no vascular resection groups. Among patients with vascular involvement, those who underwent aggressive surgical approach with vascular resection had a significantly higher OS (66.3 months vs. 25.6 months) compared to those who underwent palliative resection, without an increase in mortality or complication rate. No significant differences were observed in postoperative morbidity, 30-day mortality, or estimated median OS between patients who underwent primary repair and reconstruction.
In patients with RPS with vascular involvement, an aggressive surgical approach with vascular resection achieved optimal clinical outcomes. Vascular reconstruction techniques had no impact on clinical outcomes.
在腹膜后肉瘤（RPS）中，为实现切缘阴性，常常需要整块切除包括主要血管在内的相邻结构。然而，血管受累及不同重建技术对接受血管切除患者的影响仍不明确。本研究调查了接受积极手术方法联合血管切除治疗RPS患者的发病率、死亡率和长期生存率。
我们分析了一个前瞻性维护的数据库，该数据库包含2015年至2020年间接受RPS手术切除（有或无血管切除）的患者。主要终点是长期总生存（OS）。
研究人群包括252例患者。血管切除组和非血管切除组之间的术后发病率、死亡率和OS无显著差异。在血管受累的患者中，与接受姑息性切除的患者相比，接受积极手术方法联合血管切除的患者OS显著更高（66.3个月对25.6个月），且死亡率或并发症发生率没有增加。接受一期修复和重建的患者之间在术后发病率、30天死亡率或估计中位OS方面未观察到显著差异。
在血管受累的RPS患者中，积极手术方法联合血管切除可实现最佳临床结局。血管重建技术对临床结局无影响。
