Impact of three‐dimensional–printing technology guidance on surgical outcomes for retroperitoneal sarcoma: A propensity score‐matched study

Abstract Background The surgical treatment of retroperitoneal sarcoma (RPS) is highly challenging because of its complex anatomy. In this study, the authors compared the surgical outcomes of patients with RPS who underwent surgical resection guided by three‐dimensional (3D) printing technology versus traditional imaging. Methods This retrospective study included 251 patients who underwent RPS resection guided by 3D‐printing technology or traditional imaging from January 2019 to December 2022. The main outcome measures were operative time, intraoperative blood loss, postoperative complications, and hospital stay. Results In total, 251 patients were enrolled in the study: 46 received 3D‐printed navigation, and 205 underwent traditional surgical methods. Propensity score matching yielded 44 patients in the 3D group and 82 patients in the control group. The patients' demographics and tumor characteristics were comparable in the matched cohorts. The 3D group had significantly shorter operative time (median, 186.5 minutes [interquartile range (IQR), 130.0–251.3 minutes] vs. 210.0 minutes [IQR, 150.8–277.3 minutes]; p = .04), less intraoperative blood loss (median, 300.0 mL [IQR, 100.0–575.0 mL] vs. 375.0 mL [IQR, 200.0–925.0 mL]; p = .02), shorter postoperative hospital stays (median, 11.0 days [IQR, 9.0–13.0 days] vs. 14.0 days [IQR, 10.8–18.3 days]; p = .02), and lower incidence rate of overall postoperative complications than the control group (18.1% vs. 36.6%; p = .03). There were no differences with regard to the intraoperative blood transfusion rate, the R0/R1 resection rate, 30‐day mortality, or overall survival. Conclusions Patients in the 3D group had favorable surgical outcomes compared with those in the control group. These results suggest that 3D‐printing technology might overcome challenges in RPS surgical treatment. Plain Language Summary The surgical treatment of retroperitoneal sarcoma (RPS) is highly challenging because of its complex anatomy. The purpose of this study was to investigate whether three‐dimensional (3D) printing technology offers advantages over traditional two‐dimensional imaging (such as computed tomography and magnetic resonance imaging) for guiding the surgical treatment of RPS. In a group of patients who had RPS, surgery guided by 3D‐printing technology was associated with better surgical outcomes, including shorter operative time, decreased blood loss, shorter hospital stays, and fewer postoperative complications. These findings suggested that 3D‐printing technology could help surgeons overcome challenges in the surgical treatment of RPS. 3D‐printing technology has important prospects in the surgical treatment of RPS.