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Prosthetic Replacement of the Infrahepatic Inferior Vena Cava for Leiomyosarcoma
Giulio Illuminati, MD;
Francesco G. Calio’, MD;
Antonio D’Urso, MD;
Daniela Giacobbi, MD;
Vassilios Papaspyropoulos, MD;
Gianluca Ceccanei, MD
Arch Surg. 2006;141:919-924.
Hypothesis Resection of the infrahepatic inferior vena cava associated with prosthetic graft replacement for caval leiomyosarcoma is an acceptable procedure to obtain prolonged and good-quality survival.
Design A consecutive sample clinical study with a mean follow-up of 40 months.
Setting The surgical department of an academic tertiary center and an affiliated secondary care center.
Patients Eleven patients, with a mean age of 51 years, who have primary leiomyosarcoma of the infrahepatic inferior vena cava.
Interventions All of the patients underwent radical resection of the tumor en bloc with the affected segment of the vena cava. Reconstruction consisted of 10 cavocaval polytetrafluoroethylene grafts and 1 cavobiliac graft. An associated right nephrectomy was performed in 2 cases. The left renal vein was reimplanted in the graft in 3 cases.
Main Outcome Measures Cumulative disease-specific survival, disease-free survival, and graft patency rates expressed by standard life-table analysis.
Results No patients died in the postoperative period. The cumulative (SE) disease-specific survival rate was 53% (21%) at 5 years. The cumulative (SE) disease-free survival rate was 44% (19%) at 5 years. The cumulative (SE) graft patency rate was 67% (22%) at 5 years.
Conclusion Radical resection followed by prosthetic graft reconstruction is a valuable method for treating primary leiomyosarcoma of the infrahepatic inferior vena cava.
Author Affiliations: The "Francesco Durante" Department of Surgery, University of Rome "La Sapienza," Rome (Drs Illuminati, D’Urso, Giacobbi, Papaspyropoulos, and Ceccanei), and the Unit of Vascular Surgery, Sant’Anna Hospital, Catanzaro (Dr Calio’), Italy.
RELATED ARTICLE
Prosthetic Replacement of the Infrahepatic Inferior Vena Cava for Leiomyosarcoma—Invited Critique
William J. Quinones-Baldrich
Arch Surg. 2006;141(9):924.
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