Right primary retroperitoneal sarcoma requiring liver resection: A 20-year experience from three European referral centers
- Journal
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Q1)
- Published
- 24 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 4, Very Low (CEBM 4)
- Authors
- Emmanuel Zappettini, George Filippo Formenti Ujlaki, Dimitri Tzanis, Laura Sama, Dario Callegaro, Toufik Bouhadiba, et al.
- PMID
- 42854355
- DOI
- 10.1016/j.ejso.2026.112173
Why clinicians should know about it
- Picked for Surgery (paper of the day, 12 October 2026): Liver resection for right retroperitoneal sarcoma outcomes
Abstract
BACKGROUND: Liver resection is infrequently required during multivisceral surgery for right-sided retroperitoneal sarcomas (RPS), and outcomes in this setting remain poorly defined. This study aimed to better characterize perioperative and oncologic outcomes in this subgroup. METHODS: We conducted a retrospective cohort study across three tertiary centers, including adult patients (≥18 years) who underwent liver resection for macroscopic tumor infiltration during surgery for primary right-sided RPS between January 1, 2004, and June 30, 2024. Adverse events were graded using the Clavien-Dindo classification. Overall survival (OS) was estimated using the Kaplan-Meier method. RESULTS: Among 826 patients undergoing surgery for right-sided RPS, 24 (3%) required concomitant liver resection. Procedures included single segmentectomy (n = 13, 54%), bisegmentectomy (n = 5, 21%), right hepatectomy (n = 5, 20%), and left hepatectomy (n = 1, 4%). All patients underwent additional organ resection, most commonly colon or kidney. R0/R1 resection was achieved in all cases. Major complications (Clavien-Dindo grade III-IV) occurred in six patients (25%), and one patient (4%) died from intraoperative hemorrhage. After a median follow-up of 94.5 months (IQR, 19-105), estimated 3- and 5-year OS rates were 71% (95% CI, 52-90) and 46% (95% CI, 27-65), respectively. CONCLUSIONS: Liver resection in the context of multivisceral resection for primary RPS is feasible and it is associated to prolonged survival in almost half of the patients. Liver involvement should not be considered an absolute contraindication in selected patients. These complex procedures should be performed in high-volume centers with expertise in both sarcoma and hepatobiliary surgery.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.