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Organo Oficial de la Sociedad Mexicana de Urología

2009, Number 2

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Rev Mex Urol 2009; 69 (2)

Nephrectomy in the treatment of retroperitoneal sarcoma

Medina-Villaseñor EA, Martínez-Macías R, Quezada-Adame I, Díaz-Rodríguez L, Barra-Martínez R, Neyra-Ortiz E

Language: Spanish
References: 30
Page: 57-62
PDF size: 173.42 Kb.


ABSTRACT

Introduction: Complete retroperitoneal sarcoma resection requires the inclusion of adjacent organs, the kidney being the most frequent.
Objective: To analyze the role of nephrectomy in the treatment of retroperitoneal sarcoma.
Materials and Methods: A retrospective study of nephrectomies in retroperitoneal sarcoma performed at the Mixed Tumor Unit of the Oncology Service at the Hospital General de México was carried out from January 1999 to December 2002. Factors associated with survival were analyzed statistically.
Results: From a total of 59 patients presenting with retroperitoneal sarcoma, 11 (18.6%) required nephrectomy - 6 men (54.5%) and 5 women (45.5%). Mean age was 47 years (range of 17-75 years) with 5 patients older than 50 years of age (45.5%). Liposarcoma was found in 45.5% of patients and leiomyosarcoma in 27.2%. Tumor grade was high in 7 cases and low in 4. Complete resection was performed in 8 patients (72.7%) and partial resection in 3. There was no disease invasion in 4 kidneys (36.6%), 6 presented with capsular invasion (54.5%) and 1 presented with invasion of the parenchyma (9%). Complete resection was associated with a higher survival rate of 72.7% at 1 year (72.7%), while incomplete resection was associated with a survival rate of 27.7%. Mean survival rate was 60 months for low-grade tumors compared with 12 months for high-grade tumors. There was local recurrence and distance metastasis in liver and lung in 50% of patients having undergone complete resection. Adjuvant therapy showed no benefit for survival.
Conclusions: When kidney involvement is suspected, the performance of nephrectomy during complete resection of retroperitoneal tumor improves survival rate.


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