Primary mesenteric sarcomas: Collaborative experience from the Trans‐Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG)

Journal of Surgical Oncology, vol. 123, pp. 1057–1066

Abstract

BACKGROUND: Primary mesenteric soft tissue sarcomas (STS) are rare and limited evidence is available to inform management. Surgical resection is challenging due to the proximity of vital structures and a need to preserve enteric function. OBJECTIVES: To determine the overall survival (OS) and recurrence-free survival (RFS) for patients undergoing primary resection for mesenteric STS. METHODS: The Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) is an intercontinental collaborative comprising specialist sarcoma centers. Data were collected retrospectively for all patients with mesenteric STS undergoing primary resection between 2000 and 2019. RESULTS: Fifty-six cases from 15 institutions were included. The spectrum of pathology was similar to the retroperitoneum, although of a higher grade. R0/R1 resection was achieved in 87%. Median OS was 56 months. OS was significantly shorter in higher-grade tumors (p = .018) and extensive resection (p < .001). No significant association between OS and resection margin or tumor size was detected. Rates of local recurrence (LR) and distant metastases (DM) at 5 years were 60% and 41%, respectively. Liver metastases were common (60%), reflecting portal drainage of the mesentery. CONCLUSION: Primary mesenteric sarcoma is rare, with a modest survival rate. LR and DM are frequent events. Liver metastases are common, highlighting the need for surveillance imaging.

Authors 27

1. Hannah L. Tattersall

   University Hospitals Birmingham NHS Foundation Trust · Queen Elizabeth Hospital Birmingham

   Affiliation as printed

   Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital University Hospitals Birmingham Birmingham UK

   Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK

2. James A. Hodson

   University Hospitals Birmingham NHS Foundation Trust

   Affiliation as printed

   Department of Medical Statistics University Hospitals Birmingham NHS Foundation Trust Birmingham UK

   Department of Medical Statistics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

3. Kenneth Cardona

   Emory University Hospital · Winship Cancer Institute

   Affiliation as printed

   Department of Surgery, Winship Cancer Institute Emory University Hospital Atlanta GA USA

   Department of Surgery, Winship Cancer Institute, Emory University Hospital, Atlanta, GA, USA

4. Rachel M. Lee

   Emory University Hospital · Winship Cancer Institute

   Affiliation as printed

   Department of Surgery, Winship Cancer Institute Emory University Hospital Atlanta GA USA

   Department of Surgery, Winship Cancer Institute, Emory University Hospital, Atlanta, GA, USA

5. Carolyn Nessim

   University of Ottawa · Ottawa Hospital

   Affiliation as printed

   Department of Surgery, The Ottawa Hospital University of Ottawa Ottawa Canada

   Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada

6. Rebecca Anne Gladdy

   Mount Sinai Hospital · University of Toronto · Princess Margaret Cancer Centre

   Affiliation as printed

   Department of Surgical Oncology, Mount Sinai Hospital and Princess Margaret Cancer Centre University of Toronto Toronto Canada

   Department of Surgical Oncology, Mount Sinai Hospital and Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada

7. Jos A. van der Hage Aachen Department of Surgery Leiden University Medical Centre Leiden The Netherlands Department of Surgery, Leiden University Medical Centre

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Surgery Leiden University Medical Centre Leiden The Netherlands

   Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands

8. Yvonne M. Schrage Aachen Department of Surgery Leiden University Medical Centre Leiden The Netherlands Department of Surgery, Leiden University Medical Centre

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Surgery Leiden University Medical Centre Leiden The Netherlands

   Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands

9. William W. Tseng

   University of Southern California

   Affiliation as printed

   Division of Breast, Endocrine and Soft Tissue Surgery, Department of Surgery, Keck School of Medicine University of Southern California Los Angeles California USA

   Division of Breast, Endocrine and Soft Tissue Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA

10. Winan J. van Houdt

    The Netherlands Cancer Institute

    Affiliation as printed

    Department of Surgical Oncology The Netherlands Cancer Institute Amsterdam the Netherlands

    Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands

11. Marko Novak

    Institute of Oncology Ljubljana

    Affiliation as printed

    Department of Surgical Oncology Institute of Oncology Ljubljana Slovenia

    Department of Surgical Oncology, Institute of Oncology, Ljubljana, Slovenia

12. Giovanni Grignani

    Candiolo Cancer Institute

    Affiliation as printed

    Department of Surgical Oncology Candiolo Cancer Institute Candiolo Italy

    Department of Surgical Oncology, Candiolo Cancer Institute, Candiolo, Italy

13. Francesco Tolomeo

    Candiolo Cancer Institute

    Affiliation as printed

    Department of Surgical Oncology Candiolo Cancer Institute Candiolo Italy

    Department of Surgical Oncology, Candiolo Cancer Institute, Candiolo, Italy

14. Neha Goel

    Jackson Memorial Hospital

    Affiliation as printed

    Department of Surgical Oncology Jackson Memorial Hospital Miami USA

    Department of Surgical Oncology, Jackson Memorial Hospital, Miami, USA

15. Emily Leah Ryon

    Jackson Memorial Hospital

    Affiliation as printed

    Department of Surgical Oncology Jackson Memorial Hospital Miami USA

    Department of Surgical Oncology, Jackson Memorial Hospital, Miami, USA

16. David E. Gyorki

    Peter MacCallum Cancer Centre

    Affiliation as printed

    Division of Cancer Surgery Peter MacCallum Cancer Centre Melbourne Australia

    Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia

17. Sanjay Prakash Bagaria

    Mayo Clinic · Mayo Clinic in Florida

    Affiliation as printed

    Department of Surgery Mayo Clinic Jacksonville Jacksonville Florida USA

    Department of Surgery, Mayo Clinic Jacksonville, Jacksonville, Florida, USA

18. Ana Belén Martín Arnau

    Hospital de Sant Pau

    Affiliation as printed

    Department of Surgery Sant Pau Hospital Barcelona Spain

    Department of Surgery, Sant Pau Hospital, Barcelona, Spain

19. Raza Hasnain Sayyed
    Affiliation as printed

    Department of Surgery Patel Hospital Karachi Pakistan

    Department of Surgery, Patel Hospital, Karachi, Pakistan

20. Fabio Tirotta

    University Hospitals Birmingham NHS Foundation Trust · Queen Elizabeth Hospital Birmingham

    Affiliation as printed

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital University Hospitals Birmingham Birmingham UK

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK

21. Caroline Evenden

    University Hospitals Birmingham NHS Foundation Trust · Queen Elizabeth Hospital Birmingham

    Affiliation as printed

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital University Hospitals Birmingham Birmingham UK

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK

22. Anant Desai

    University Hospitals Birmingham NHS Foundation Trust · Queen Elizabeth Hospital Birmingham

    Affiliation as printed

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital University Hospitals Birmingham Birmingham UK

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK

23. Max Almond

    University Hospitals Birmingham NHS Foundation Trust · Queen Elizabeth Hospital Birmingham

    Affiliation as printed

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital University Hospitals Birmingham Birmingham UK

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK

24. James C Glasbey

    University Hospitals Birmingham NHS Foundation Trust · Queen Elizabeth Hospital Birmingham

    Affiliation as printed

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital University Hospitals Birmingham Birmingham UK

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK

25. Marco Fiore

    Fondazione IRCCS Istituto Nazionale dei Tumori

    Affiliation as printed

    Department of Surgery Fondazione IRCSS Istituto Nazionale dei Tumori Milan Italy

    Department of Surgery, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy

26. Alessandro Gronchi

    Fondazione IRCCS Istituto Nazionale dei Tumori

    Affiliation as printed

    Department of Surgery Fondazione IRCSS Istituto Nazionale dei Tumori Milan Italy

    Department of Surgery, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy

27. Samuel Ford corresponding

    University Hospitals Birmingham NHS Foundation Trust · Queen Elizabeth Hospital Birmingham

    Affiliation as printed

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital University Hospitals Birmingham Birmingham UK

    Midlands Abdominal and Retroperitoneal Sarcoma Unit, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK