Leiomyosarcoma of the Inferior Vena Cava: Survival After Aggressive Management View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2007-12

AUTHORS

Hiromichi Ito, Jason L. Hornick, Monica M. Bertagnolli, Suzanne George, Jeffrey A. Morgan, Elizabeth H. Baldini, Andrew J. Wagner, George D. Demetri, Chandrajit P. Raut

ABSTRACT

BACKGROUND: Leiomyosarcoma (LMS) of the inferior vena cava (IVC) is exceedingly rare. The role of adjuvant therapy remains undefined. This study evaluated outcomes after aggressive management. METHODS: Records on 20 patients undergoing surgery for IVC LMS between January 1990 and April 2006 were retrieved. Histology was confirmed upon re-review. Most patients received perioperative chemotherapy (CT), radiation therapy (RT), or both (CRT). Disease-free and overall survival (DFS, OS) rates were calculated using the Kaplan-Meier method. RESULTS: Twenty patients (60% women, median age 57 years) with primary IVC LMS were treated with curative intent. Median follow-up was 41 months. All patients underwent resection of the primary tumor; one was found to have unresectable liver metastases. The IVC was managed with ligation (3), primary repair (12), or prosthetic graft (5). Additional organs were resected in 14 (70%) patients. Chemotherapy and/or RT were administered to 9 (45%) patients preoperatively (CT 2, RT 6, CRT 1) and 8 (40%) postoperatively (CT 4, RT 1, CRT 3). Median DFS was 21 months. Of 13 (68%) patients who developed recurrence, 4 underwent surgery, and 11 received CT. Median OS for 19 patients who underwent complete resection was 71 months. Tumor size was associated with disease recurrence (P = .004). No variables were prognostic for OS. CONCLUSIONS: Patients with IVC LMS treated with curative intent develop early recurrent disease. Nevertheless, long-term OS can be achieved even in the setting of metastatic disease. The independent impact of perioperative CT, RT, or CRT treatments cannot be adequately determined. More... »

PAGES

3534

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Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-007-9552-z

DOI

http://dx.doi.org/10.1245/s10434-007-9552-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1040968282

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/17896156


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