Postoperative morbidity and mortality in a large series of primary retroperitoneal sarcoma (RPS) treated at 8 tertiary centers: A study from the Transatlantic RPS Working Group.
Bibliographic record
Abstract
10557 Background: To explore postoperative morbidity and mortality of patients (pts) with primary retroperitoneal sarcoma (RPS) undergoing surgery at 8 high volume centers (the Transatlantic RPS working group). Methods: All consecutive pts with primary RPS treated at 2 North American and 6 European centers between 2002 and 2011 were included in a retrospective analysis. Postoperative adverse events according to Common Terminology Criteria for Adverse Events (CTCAE) and mortality at 30, 60 and 90 days were analyzed. Overall survival (OS), local recurrence (LR) and distant metastasis (DM) calculated. Multivariate analysis performed exploring risk factors for postoperative complications considering age, size, number and type of resected organs, preoperative chemotherapy and radiotherapy. Results: Total of 1007 pts were included in the database. Median follow-up was 58 months (range 36-90mo). Five and 10yr OS, LR and DM were 67% and 46%, 26% and 35%, 21% and 22% respectively. Postoperative complications of CTCAE grade ≥ 3 were observed in 207 pts (21%); grade 3 complications in 128 pts (12.7%), grade 4 in 52 pts (5.2%) and grade 5 for 19 pts (1.9%). The postoperative complication rate varied from 14.4 to 37.0% among centers. The re-operation rate was 10.5%. Most common complications were postoperative bleeding/hematoma (3.0%), bowel anastomotic leak/fistula (2.6%) and bowel obstruction/ileus (2.3%). The 30, 60 and 90-day mortality rate were 1.8 (95% CI 1-2.6), 2.9 (95% CI 1.8-3.9) and 4.1% (95% CI 2.9-5.3) respectively. In multivariable analysis, the occurrence of a postoperative complication was significantly associated with worst OS (HR 1.54, 95% CI 1.08-2.19, p = 0.016) and higher LR rate (HR 1.59, 95% CI 1.09-2.30, p = 0.015) while it was not significantly associated with a worst DM rate (HR 1.33, 95% CI 0.90-1.98, p = 0.153). Conclusions: Data about short-term morbidity are consistent with previous studies on RPS and comparable to those other major abdominal cancer surgery. The balance between the expected morbidity and the possible improvement in oncologic outcome should be factored in the management algorithm and tailored to the patient.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".