J Monteiro De Barros
Intercontinental collaborative experience with abdominal, retroperitoneal and pelvic schwannomas
Monteiro De Barros, J; Hodson, J; Glasbey, J; Massey, R; Rintoul-Hoad, O; Chetan, M; Desai, A; Almond, LM; Gourevitch, D; Ford, SJ; Strauss, D; Smith, H; Hayes, A; Cardona, K; Lopez-Aguiar, A; Johnson, A; Swallow, C; Burtenshaw, S; Nessim, C; Weng, R; Purgin, B; Gronchi, A; Fiore, M; Callegaro, D; Raut, CP; Fairweather, M; Bagaria, S; Novak, M; Gyorki, D; Reid, F; Mullinax, J; Gonzalez, RJ; Van Coevorden, F; Van Houdt, W; Haas, RLM; Van Boven, H; Heeres, B
Authors
J Hodson
J Glasbey
Professor Richard Massey r.j.massey@durham.ac.uk
Professor
O Rintoul-Hoad
M Chetan
A Desai
LM Almond
D Gourevitch
SJ Ford
D Strauss
H Smith
A Hayes
K Cardona
A Lopez-Aguiar
A Johnson
C Swallow
S Burtenshaw
C Nessim
R Weng
B Purgin
A Gronchi
M Fiore
D Callegaro
CP Raut
M Fairweather
S Bagaria
M Novak
D Gyorki
F Reid
J Mullinax
RJ Gonzalez
F Van Coevorden
W Van Houdt
RLM Haas
H Van Boven
B Heeres
Abstract
Background Schwannomas are rare tumours that pose a significant management challenge in the abdomen, retroperitoneum and pelvis. No data are available to inform management strategy. Methods A collaborative international cohort study, across specialist sarcoma units, was conducted to include adults presenting between 2000 and 2017 with histopathologically confirmed schwannomas within the abdomen, retroperitoneum or pelvis. Results Of 485 patients across 12 centres, 38 (7·8 per cent) were discharged without follow-up, 199 (41·0 per cent) underwent early resection and 248 (51·1 per cent) had radiological monitoring. Of these 248 patients, 96 (38·7 per cent) eventually had surgery, giving an overall resection rate of 60·8 per cent (295 of 485). At baseline, median tumour volume was 90·1 (i.q.r. 26·5–262·0) cm3. The estimated growth rate was 10·5 (95 per cent c.i. 9·4 to 11·6) per cent per year, and was consistent in the short term (within 2 years of diagnosis) and long term (beyond 2 years) (ρ = 0·405, P = 0·021). A decision to operate was more common in symptomatic patients (P < 0·001) and for rapidly growing tumours (growth rate more than 20 per cent per year) (P = 0·025). R0/R1 resection was achieved in 91·6 per cent of patients (263 of 287). Kaplan–Meier long-term recurrence rates after R0/R1 resection were 2·3 and 6·7 per cent at 3 and 5 years respectively. Conclusion Specific recommendations include: indications for early surgery, prediction of growth from radiological monitoring, promotion of selective submacroscopic resection and cessation of postoperative imaging surveillance.
Citation
Monteiro De Barros, J., Hodson, J., Glasbey, J., Massey, R., Rintoul-Hoad, O., Chetan, M., …Heeres, B. (2019). Intercontinental collaborative experience with abdominal, retroperitoneal and pelvic schwannomas. British Journal of Surgery, 107(4), 452-563. https://doi.org/10.1002/bjs.11376
Journal Article Type | Article |
---|---|
Acceptance Date | Aug 30, 2019 |
Online Publication Date | Mar 1, 2020 |
Publication Date | 2019-03 |
Deposit Date | Sep 28, 2021 |
Publicly Available Date | Oct 1, 2021 |
Journal | British Journal of Surgery |
Print ISSN | 0007-1323 |
Electronic ISSN | 1365-2168 |
Publisher | British Journal of Surgery Society |
Peer Reviewed | Peer Reviewed |
Volume | 107 |
Issue | 4 |
Pages | 452-563 |
DOI | https://doi.org/10.1002/bjs.11376 |
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Copyright Statement
This is a pre-copyedited, author-produced version of an article accepted for publication in British Journal of Surgery following peer review. The version of record Monteiro De Barros, J, Hodson, J, Glasbey, J, Massey, R, Rintoul-Hoad, O, Chetan, M, Desai, A, Almond, L M, Gourevitch, D, Ford, S J, Strauss, D, Smith, H, Hayes, A, Cardona, K, Lopez-Aguiar, A, Johnson, A, Swallow, C, Burtenshaw, S, Nessim, C, Weng, R, Purgin, B, Gronchi, A, Fiore, M, Callegaro, D, Raut, C P, Fairweather, M, Bagaria, S, Novak, M, Gyorki, D, Reid, F, Mullinax, J, Gonzalez, R J, Van Coevorden, F, Van Houdt, W, Haas, R L M, Van Boven, H & Heeres, B (2019). Intercontinental collaborative experience with abdominal, retroperitoneal and pelvic schwannomas. British Journal of Surgery 107(4): 452-563. is available online at: https://doi.org/10.1002/bjs.11376
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