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Der Chirurg; Zeitschrift Fur Alle... Jan 2022Retroperitoneal soft tissue sarcomas (RPS) include tumors of mesenchymal origin with overall well-defined histological subtypes and heterogenic prognosis. For the first... (Review)
Review
BACKGROUND
Retroperitoneal soft tissue sarcomas (RPS) include tumors of mesenchymal origin with overall well-defined histological subtypes and heterogenic prognosis. For the first time with the publication of the STRASS study, which investigated the value of neoadjuvant radiotherapy in primary RPS, there is phase III evidence for the use of radiotherapy.
OBJECTIVE
The primary objective of the present article is to present the role of neoadjuvant radiotherapy in RPS since the publication of the STRASS study.
MATERIAL AND METHODS
We performed a non-systematic literature search. The results of retrospective and observational studies were compared to those of the STRASS study.
RESULTS
In the two of the largest analyses, the surveillance, epidemiology, and end results program (SEER) and the American National Cancer Database (NCDB), an improvement in overall survival due to radiotherapy in RPS could be shown. In contrast to these results, there was no significant improvement in 3‑year abdominal recurrence-free survival in the STRASS study. There was solely a trend to improved abdominal recurrence-free survival in initially unplanned subgroup analyses for patients with liposarcoma as well as low-grade sarcoma but not for leiomyosarcoma or high-grade sarcoma.
CONCLUSION
Thanks to international collaboration an academic randomized trial was even feasible in such a rare disease as RPS. The results of the STRASS study have relativized the potential benefit of radiotherapy in RPS. A longer follow-up especially regarding the role of radiotherapy in liposarcomas is desirable.
Topics: Humans; Neoplasm Recurrence, Local; Retroperitoneal Neoplasms; Retrospective Studies; Sarcoma; Soft Tissue Neoplasms
PubMed: 34524488
DOI: 10.1007/s00104-021-01498-3 -
Current Opinion in Oncology Jul 2023Retroperitoneal soft-tissue sarcomas (RPS) are a group of rare, histologically distinct tumours with variable recurrence patterns depending on histological type. This... (Review)
Review
PURPOSE OF REVIEW
Retroperitoneal soft-tissue sarcomas (RPS) are a group of rare, histologically distinct tumours with variable recurrence patterns depending on histological type. This review will discuss the growing body of evidence supporting histology-specific, multidisciplinary management and highlight areas of future research for patients with RPS.
RECENT FINDINGS
Histology-tailored surgery is the cornerstone of management in patients with localized RPS. Further efforts to develop resectability criteria and identify patients who will benefit from neoadjuvant treatment strategies will help standardize the treatment of patients with localized RPS. Surgery for local recurrence is well tolerated in selected patients and re-iterative surgery in liposarcoma (LPS) may be beneficial at the time of local recurrence. The management of advanced RPS holds promise with several trials currently investigating systemic treatment beyond conventional chemotherapy.
SUMMARY
The management of RPS has made significant progress over the past decade owing to international collaboration. Ongoing efforts to identify patients who will derive the most benefit from all treatment strategies will continue to advance the field of RPS.
Topics: Humans; Sarcoma; Neoadjuvant Therapy; Retroperitoneal Neoplasms; Soft Tissue Neoplasms; Neoplasm Recurrence, Local
PubMed: 37222202
DOI: 10.1097/CCO.0000000000000954 -
Current Opinion in Oncology Jul 2017Retroperitoneal sarcomas are rare tumors and with complex treatment. In this manuscript we give an overview of current standards in treatment of this disease and discuss... (Review)
Review
PURPOSE OF REVIEW
Retroperitoneal sarcomas are rare tumors and with complex treatment. In this manuscript we give an overview of current standards in treatment of this disease and discuss new developments.
RECENT FINDINGS
Surgery with complete resection of the primary tumor is still the only curative modality. The role of preoperative radiotherapy is not clear and is currently being investigated in a clinical trial. Neo-adjuvant chemotherapy is not the standard of care but can be considered occasionally when complete resection is uncertain. Local and distant recurrent disease carries a dismal prognosis, although long-term survival can be achieved. Liposarcomas tend to recur locally, whereas distant recurrences are more often seen in leiomyosarcoma and other subtypes. Outcome improves when patients are treated in high volume sarcoma centers. In the metastatic setting, newer systemic agents have recently been approved.
SUMMARY
Treatment of retroperitoneal sarcomas is complex and all patients should be treated in multidisciplinary sarcoma centers. Increasing international collaboration of expert centers in sharing expertise and performing clinical trials might lead to better treatment and improved survival.
Topics: Chemotherapy, Adjuvant; Humans; Neoadjuvant Therapy; Radiotherapy, Adjuvant; Randomized Controlled Trials as Topic; Retroperitoneal Neoplasms; Sarcoma
PubMed: 28509807
DOI: 10.1097/CCO.0000000000000377 -
Journal of Surgical Oncology Mar 2016Surgery is the "gold-standard" treatment for retroperitoneal sarcomas, but local recurrence is common, and can cause disease-related death. Complete gross resection is... (Review)
Review
Surgery is the "gold-standard" treatment for retroperitoneal sarcomas, but local recurrence is common, and can cause disease-related death. Complete gross resection is associated with improved survival, but debate exists as to whether resection of adjacent organs to improve margins or prescription of neoadjuvant radiation leads to better outcomes. This review summarizes data addressing prognostic value of margin, extent of surgery necessary to optimize treatment of retroperitoneal sarcomas, and role of histology in optimizing therapy.
Topics: Chemotherapy, Adjuvant; Humans; Leiomyosarcoma; Liposarcoma; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Neoplasm, Residual; Prognosis; Radiotherapy, Adjuvant; Retroperitoneal Neoplasms; Sarcoma; Surgical Procedures, Operative; Survival Rate; Treatment Outcome
PubMed: 26707028
DOI: 10.1002/jso.24135 -
Journal of Pediatric Surgery Oct 2019Variations in vascular anatomy (VIVAs) of the retroperitoneal great vessels are uncommon but can potentially complicate surgical procedures and negatively affect...
BACKGROUND/OBJECTIVES
Variations in vascular anatomy (VIVAs) of the retroperitoneal great vessels are uncommon but can potentially complicate surgical procedures and negatively affect treatment outcomes, yet their incidence and clinical impact are poorly studied. We sought to assess the incidence and clinical impact of VIVAs of retroperitoneal great vessels in patients with retroperitoneal tumors.
METHODS
We retrospectively analyzed imaging, surgical, treatment and survival data of all pediatric patients with retroperitoneal tumors who underwent resection between January 2007 and October 2016, comparing preoperative scans with corresponding intraoperative observations, and subsequent surgical outcomes.
RESULTS
Among 66 children with renal, adrenal and paravertebral tumors, 6 (9%) had retroperitoneal VIVAs. Retroperitoneal VIVAs were present only with right-sided tumors and significantly associated with more frequent intraoperative complications (P = 0.013). While the presence of retroperitoneal VIVAs was not directly associated with survival outcomes, relapse was more frequent in patients with VIVAs (33%) than those without (18.3%, P = 0.378), and relapse was also associated with lower overall and event-free survival (P < 0.001).
CONCLUSIONS
VIVAs of retroperitoneal great vessels occurred in 9% of our patients with retroperitoneal tumors. Retroperitoneal VIVAs were associated with higher rates of intraoperative complications and disease relapse but was not directly related to survival outcomes.
TYPE OF STUDY
Retrospective review study.
LEVEL OF EVIDENCE
Level III Retrospective comparative study.
Topics: Adolescent; Adrenal Gland Neoplasms; Child; Child, Preschool; Disease-Free Survival; Female; Humans; Intraoperative Complications; Kidney Neoplasms; Male; Neoplasm Recurrence, Local; Retroperitoneal Neoplasms; Retroperitoneal Space; Retrospective Studies; Spinal Neoplasms; Treatment Outcome; Vascular Malformations
PubMed: 30765156
DOI: 10.1016/j.jpedsurg.2019.01.002 -
Gynecologic and Obstetric Investigation 2016The aim of this study was to perform a systematic review on primary retroperitoneal cystoadenocarcinoma (PRC), which is an extremely rare disease. (Review)
Review
BACKGROUND/AIMS
The aim of this study was to perform a systematic review on primary retroperitoneal cystoadenocarcinoma (PRC), which is an extremely rare disease.
METHODS
According to PRISMA guidelines, all the literature about PRC from 1977 to 2015 was reviewed. Thirty articles were selected; characteristics of the patients were collected and described; time to recurrence and overall survival (OS) were investigated when available.
RESULTS
Thirty seven patients were included of whom 33 were females; the median age at presentation was 43. PRC was more common in postmenopausal women. Surgery was the standard therapy; the role of chemotherapy and/or radiotherapy was uncertain. Thirty percent of the patients relapsed after 58 months from the surgery; the rupture of the cyst occurred in 13% of the cases and it was associated with poor prognosis as well as premenopausal status. At 125 months from the diagnosis, 72% of the patients were alive and the median OS was not reached.
CONCLUSIONS
The present systematic review about PRC is the first performed until the date of drafting this paper. We described some clinical features of PRC and their possible prognostic value. No conclusive data can be presented due to the small population analyzed and to publication bias.
Topics: Cystadenocarcinoma; Humans; Neoplasm Recurrence, Local; Prognosis; Retroperitoneal Neoplasms
PubMed: 27309542
DOI: 10.1159/000446954 -
Radiographics : a Review Publication of... Oct 2020(Review)
Review
Topics: Diagnosis, Differential; Diagnostic Imaging; Humans; Retroperitoneal Neoplasms
PubMed: 33001785
DOI: 10.1148/rg.2020200015 -
Abdominal Radiology (New York) Jan 2017
Review
Topics: Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Retroperitoneal Neoplasms; Tomography, X-Ray Computed
PubMed: 27470508
DOI: 10.1007/s00261-016-0852-2 -
Khirurgiia 2021To assess the influence of active surgical approach on the long-term postoperative outcomes in patients with retroperitoneal liposarcoma.
OBJECTIVE
To assess the influence of active surgical approach on the long-term postoperative outcomes in patients with retroperitoneal liposarcoma.
MATERIAL AND METHODS
A retrospective study included 190 patients with retroperitoneal liposarcoma. The effect of malignancy grade, adjuvant chemotherapy, number of separate tumor nodes in primary neoplasm and the first relapse, as well as the number of previous total resections on survival rate was analyzed.
RESULTS
Overall and relapse-free survival is significantly worse in patients with high-grade retroperitoneal liposarcoma (G2-3) compared to low-grade (G1) tumor (=0.000). Multifocal growth of primary tumor (=0.869; =0.607) and multiple (>1) separately located nodes in abdominal cavity and retroperitoneal space at the first relapse (=0.158 to 0.985) did not significantly impair prognosis after total resection of all types of retroperitoneal liposarcoma regardless malignancy grade. Adjuvant chemotherapy does not significantly improve relapse-free survival. Overall survival was significantly higher in patients who underwent ≥4 previous total resections compared to 1 surgical treatment for all types of retroperitoneal liposarcoma regardless malignancy grade (=0.000; =0.001).
CONCLUSION
The only potentially radical treatment for patients with retroperitoneal liposarcoma is surgery. We reported the advantages of active surgical approach for improvement of long-term outcomes in patients with retroperitoneal liposarcoma.
Topics: Humans; Liposarcoma; Neoplasm Recurrence, Local; Prognosis; Retroperitoneal Neoplasms; Retrospective Studies
PubMed: 34786910
DOI: 10.17116/hirurgia20211115 -
Surgical Oncology Mar 2019In the last decades, the deeper understanding of the biological basis of the disease, along with the advances of surgical techniques and oncologic multimodal treatments,... (Review)
Review
In the last decades, the deeper understanding of the biological basis of the disease, along with the advances of surgical techniques and oncologic multimodal treatments, have led to an overall increase of survival of cancer patients. However, significant amelioration of the prognosis of rare and under-investigated tumors such as soft tissue sarcoma is less evident. In this review, main changes in the surgical management of retroperitoneal sarcoma (RPS) are discussed in order to figure out whether actual improvement in RPS outcome has been occurred in the last years.
Topics: Humans; Prognosis; Retroperitoneal Neoplasms; Sarcoma; Survival Rate
PubMed: 30851921
DOI: 10.1016/j.suronc.2018.11.004