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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

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Authors

J Monteiro De Barros

J Hodson

J Glasbey

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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