{
    "abstract": "In retroperitoneal leiomyosarcoma (RP LMS), the predominant issue is distant metastasis (DM). We sought to determine variables associated with this outcome and disease-specific death (DSD).\nData were retrospectively collected on patients with primary RP LMS treated at a high-volume center from 2002 to 2023. For inferior vena cava (IVC)-origin tumors, the extent of macroscopic vascular invasion was re-assessed on each resection specimen and correlated with preoperative cross-sectional imaging. Crude cumulative incidences were estimated for DM and DSD and univariable and multivariable models were performed.\nAmong 157 study patients, median tumor size was 11.0\u2009cm and 96.2% of cases were intermediate or high grade. All patients underwent complete resection, 56.7% received chemotherapy (43.9% neoadjuvant) and 14.6% received radiation therapy. Only tumor size and grade and not site of tumor origin (e.g., IVC vs. other) were associated with DM and DSD (p\u2009<\u20090.05). Among 64 patients with IVC-origin tumors, a novel 3-tier classification was devised based on the level of intimal disruption, which was associated with both DM (p\u2009=\u20090.007) and DSD (0.002).\nIn primary RP LMS, only tumor size and grade are predictive of DM and DSD. In IVC-origin tumors, the extent of macroscopic vascular invasion is also strongly predictive of these outcomes.",
    "authors": [
        {
            "affiliation": "Department of Surgery, Division of Surgical Oncology, City of Hope National Medical Center, Duarte, California, USA.",
            "firstname": "William W",
            "initials": "WW",
            "lastname": "Tseng"
        },
        {
            "affiliation": "Department of Biostatistics for Clinical Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Francesco",
            "initials": "F",
            "lastname": "Barretta"
        },
        {
            "affiliation": "Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Marco",
            "initials": "M",
            "lastname": "Fiore"
        },
        {
            "affiliation": "Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Chiara",
            "initials": "C",
            "lastname": "Colombo"
        },
        {
            "affiliation": "Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Stefano",
            "initials": "S",
            "lastname": "Radaelli"
        },
        {
            "affiliation": "Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Marco",
            "initials": "M",
            "lastname": "Baia"
        },
        {
            "affiliation": "Deparment of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Carlo",
            "initials": "C",
            "lastname": "Morosi"
        },
        {
            "affiliation": "Soft Tissue Tumor Pathology Unit, Department of Advanced Diagnostics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Paola",
            "initials": "P",
            "lastname": "Collini"
        },
        {
            "affiliation": "Deparment of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Roberta",
            "initials": "R",
            "lastname": "Sanfilippo"
        },
        {
            "affiliation": "Deparment of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Chiara",
            "initials": "C",
            "lastname": "Fabbroni"
        },
        {
            "affiliation": "Deparment of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Silvia",
            "initials": "S",
            "lastname": "Stacchiotti"
        },
        {
            "affiliation": "Department of Surgery, Division of Thoracic Surgery (Section of Vascular Surgery), City of Hope National Medical Center, Duarte, California, USA.",
            "firstname": "Randall F",
            "initials": "RF",
            "lastname": "Roberts"
        },
        {
            "affiliation": "Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Dario",
            "initials": "D",
            "lastname": "Callegaro"
        },
        {
            "affiliation": "Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.",
            "firstname": "Alessandro",
            "initials": "A",
            "lastname": "Gronchi"
        }
    ],
    "conclusions": "In primary RP LMS, only tumor size and grade are predictive of DM and DSD. In IVC-origin tumors, the extent of macroscopic vascular invasion is also strongly predictive of these outcomes.",
    "copyrights": "\u00a9 2024 Wiley Periodicals LLC.",
    "doi": "10.1002/jso.27799",
    "journal": "Journal of surgical oncology",
    "keywords": [
        "clinical predictor",
        "distant metastasis",
        "inferior vena cava",
        "leiomyosarcoma",
        "retroperitoneal sarcoma"
    ],
    "methods": null,
    "publication_date": "2024-08-19",
    "pubmed_id": "39155701",
    "results": "Among 157 study patients, median tumor size was 11.0\u2009cm and 96.2% of cases were intermediate or high grade. All patients underwent complete resection, 56.7% received chemotherapy (43.9% neoadjuvant) and 14.6% received radiation therapy. Only tumor size and grade and not site of tumor origin (e.g., IVC vs. other) were associated with DM and DSD (p\u2009<\u20090.05). Among 64 patients with IVC-origin tumors, a novel 3-tier classification was devised based on the level of intimal disruption, which was associated with both DM (p\u2009=\u20090.007) and DSD (0.002).",
    "title": "Extent of macroscopic vascular invasion predicts distant metastasis in primary leiomyosarcoma of the inferior vena cava.",
    "xml": "<Element 'PubmedArticle' at 0x788502c65d50>"
}