Postoperative Morbidity After Radical Resection of Retroperitoneal Solitary Fibrous Tumor

Aobo Zhuang; Yuan Fang; Lijie Ma; Weiqi Lu; Hanxing Tong; Yong Zhang

doi:10.3389/fsurg.2022.833296

Postoperative Morbidity After Radical Resection of Retroperitoneal Solitary Fibrous Tumor

Front Surg. 2022 Mar 28:9:833296. doi: 10.3389/fsurg.2022.833296. eCollection 2022.

Authors

Aobo Zhuang¹, Yuan Fang¹, Lijie Ma¹, Weiqi Lu^{1

2}, Hanxing Tong^{1

2}, Yong Zhang^{1

2}

Affiliations

¹ Department of General Surgery, South Hospital of the Zhongshan Hospital/Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
² Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Abstract

Background: This study aimed to investigate the clinicopathological characteristics of retroperitoneal solitary fibrous tumor (RSFT) and the safety of radical resection.

Methods: A retrospective analysis was conducted on the data of 32 RSFT patients who received surgery with curative intent from February 2011 and June 2021.

Results: This cohort included 16 (50%) male and 16 (50%) female patients, with the median age of 52 (29 to 72) years. Tumor burden ranged from 3 to 25 (median, 10) cm. Seven patients received arterial embolization before surgery. 15 (47%) patients received radiotherapy, nine (28%) of which received preoperative radiotherapy. Most of the patients (91%) achieved complete resection with median bleeding of 400 (20 to 5,000) ml. Nine (28%) patients received packed red blood cell (RBC) transfusion, with a median of 5 (2 to 10) U. All patients had the five-year progression-free survival rate and the overall survival rate of 75.8% and 80.0%, respectively. 11 (34%) patients were found with adverse events, and four (12%) patients were found with serious postoperative complications (Clavien-Dindo ≥3), of which one (3.1%) patient died after surgery. The univariate analysis found that tumor burden (p = 0.022), packed RBC transfusion (p = 0.001) and postoperative hospital stays (0.027) were correlated with overall morbidity. The multivariate analysis found packed RBC transfusion as an independent risk factor for postoperative morbidity (HR 381.652, 95% CI, 1.597-91213.029, p = 0.033).

Conclusion: RSFT was confirmed as an uncommon, slow-growing and recurring tumor, with acceptable postoperative morbidity and mortality after surgical resection.

Keywords: morbidity; neoadjuvant radiotherapy; overall survival (OS); preoperative embolization; progression-free survival (PFS); retroperitoneal; solitary fibrous tumor.