{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T05:15:02Z","timestamp":1770354902786,"version":"3.49.0"},"reference-count":13,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["T32 CA 009599"],"award-info":[{"award-number":["T32 CA 009599"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007313","name":"MD Anderson Cancer Center","doi-asserted-by":"crossref","award":["P30 CA016672"],"award-info":[{"award-number":["P30 CA016672"]}],"id":[{"id":"10.13039\/100007313","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Retroperitoneal leiomyosarcomas are aggressive malignancies. Complete surgical resection with negative margins is crucial to decrease the risk of recurrence but can be risky due to vascular involvement. The aim of our study was to evaluate the different approaches to IVC and renal vein management and their impact on postoperative complications. Methods: We performed a retrospective review of patients who underwent surgery for retroperitoneal leiomyosarcoma with IVC and\/or renal vein involvement at our institution from 2016 to 2024. Patients were stratified by intraoperative vascular management, including ligation only versus varying forms of vascular reconstruction. Postoperative complications, including bleeding, transfusions, the need for acute and chronic hemodialysis, and thromboembolic events, were recorded. Chi-squared tests were used to compare rates of postoperative complications by vascular management. A p-value of 0.05 was considered statistically significant. Results: We identified 60 patients at our institution who underwent surgery for leiomyosarcoma with IVC and\/or renal vein involvement. Ten patients underwent IVC ligation alone due to thrombosis, thirty-six had IVC replacement, and fourteen had patch angioplasty. In the entire cohort, twenty-six patients (43.3%) experienced an adverse event after surgery. When looking at postoperative adverse events by IVC management, we did not find any statistically significant differences among rates of adverse events by group. There were also no statistically significant differences in complications following renal vein ligation versus renal vein reconstruction. Conclusions: Patients with leiomyosarcoma with IVC and\/or renal vein involvement have several options for intraoperative vascular management. Our data demonstrates that there are no statistically significant differences in rates of complications among the different groups.<\/jats:p>","DOI":"10.3390\/curroncol33020090","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:48:01Z","timestamp":1770115681000},"page":"90","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Vascular Management on Postoperative Complications in Patients Undergoing Surgery for Retroperitoneal Leiomyosarcoma"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8339-7546","authenticated-orcid":false,"given":"Neha","family":"Malik","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seokhun","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School, Houston, TX 77054, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher P.","family":"Scally","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily Z.","family":"Keung","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Lillemoe","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keila E.","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9156-8723","authenticated-orcid":false,"given":"Kelly K.","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophia","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3400-0087","authenticated-orcid":false,"given":"Christina L.","family":"Roland","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather G.","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/CCO.0000000000000377","article-title":"Treatment of retroperitoneal sarcoma: Current standards and new developments","volume":"29","author":"Zaidi","year":"2017","journal-title":"Curr. Opin. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101885","DOI":"10.1016\/j.jvsv.2024.101885","article-title":"Surgical outcomes of patients with inferior vena cava leiomyosarcoma","volume":"12","author":"Shafique","year":"2024","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jvs.2006.03.001","article-title":"Clinical results of surgery for retroperitoneal sarcoma with major blood vessel involvement","volume":"44","author":"Schwarzbach","year":"2006","journal-title":"J. Vasc. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1002\/jso.24041","article-title":"Inferior vena cava reconstruction for leiomyosarcoma of zone I\u2013III requiring complete hepatectomy and bilateral nephrectomy with autotransplantation","volume":"112","author":"Fernandez","year":"2015","journal-title":"J. Surg. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/01.sla.0000229964.71743.db","article-title":"Leiomyosarcoma of the inferior vena cava","volume":"244","author":"Kieffer","year":"2006","journal-title":"Ann. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3537","DOI":"10.1007\/s00268-020-05602-2","article-title":"Inferior vena cava leiomyosarcoma: What method of reconstruction for which type of resection?","volume":"44","author":"Gaignard","year":"2020","journal-title":"World J. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1002\/jso.27765","article-title":"Vena cava leiomyosarcoma surgery results in a retrospective cohort of 41 patients from two centers","volume":"130","author":"Bertrand","year":"2024","journal-title":"J. Surg. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.jvsv.2018.10.023","article-title":"Outcome of iliocaval resection and reconstruction for retroperitoneal sarcoma","volume":"7","author":"Ferraris","year":"2019","journal-title":"J. Vasc. Surg. Venous Lymphat. Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3500","DOI":"10.3390\/curroncol30030266","article-title":"Complex vascular resections for retroperitoneal soft tissue sarcoma","volume":"30","author":"Devaud","year":"2023","journal-title":"Curr. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.ejvssr.2017.07.001","article-title":"Vascular reconstruction technique using a tubular graft for leiomyosarcoma of the inferior vena cava: A case report","volume":"36","author":"Higutchi","year":"2017","journal-title":"EJVES Short Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1161\/ATVBAHA.109.185678","article-title":"Inferior vena cava ligation rapidly induces tissue factor expression and venous thrombosis in rats","volume":"29","author":"Zhou","year":"2009","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4787","DOI":"10.1245\/s10434-024-15324-7","article-title":"Impact of left renal vein ligation on renal function following en bloc resection of segmental inferior vena cava and right kidney","volume":"31","author":"Wang","year":"2024","journal-title":"Ann. Surg. Oncol."},{"key":"ref_13","first-page":"186","article-title":"Recovery of renal function after right nephrectomy, cavectomy and left renal vein ligation","volume":"15","author":"Cancarini","year":"2002","journal-title":"J. Nephrol."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/2\/90\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T05:17:08Z","timestamp":1770182228000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/2\/90"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,2]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["curroncol33020090"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33020090","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,2]]}}}