Objectives This study aims to review tolerability and efficacy of laterally extended endopelvic resection (LEER) in patients with pelvic sidewall sarcoma.

Methods We retrospectively reviewed medical records of patients with pelvic sidewall sarcoma who underwent LEER between 2015 and to Mar. 2021. We collected data on clinicopathologic characteristics, surgery, perioperative management, and outcomes.

Results A total of eight patients were enrolled. Patients had advanced or recurrent leiomyosarcoma, carcinosarcoma, low-grade endometrial stromal sarcoma (ESS), synovial sarcoma, and undifferentiated sarcoma. Urinary obstruction (87.5%) was the most common presentation before the surgery. Complete resection (R0) was achieved five (62.5%) patients. Median Operative time was 6 (range, 3–22) hours. Transfusion was performed in six patients (75%) with median of 2.5 pack of RBC. Four patients needed postoperative intensive care for median of two days (range, 0–8) but there was no operation-associated mortality or severe life-threatening morbidity. Median pelvic control duration was 6 (range, 3–64) months, although disease progression was observed in other extrapelvic areas where preoperatively assessed to be broadly distributed and impossible to be completely resected. Interestingly, one patients with progression disease (PD) showed 16 months of pelvic control duration. One patient showed no recurrence after the surgery (10%) and another patient showed stable disease (SD, 10%). Median OS after LEER was 6 (6–65) months.

Conclusions LEER is feasible for surgical control of the pelvic sidewall tumor with acceptable complications.