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Surgical Oncology Aug 2022Retroperitoneal and pelvis sarcomas are uncommon tumors for which complete surgical resection is the mainstay of treatment. However, achieving complete gross resection... (Review)
Review
Retroperitoneal and pelvis sarcomas are uncommon tumors for which complete surgical resection is the mainstay of treatment. However, achieving complete gross resection with microscopically negative margins is challenging, and local recurrence rates can be high. Patients often succumb to uncontrolled local disease. Radiation therapy offers a potential means for sterilizing microscopic residual disease, although its use continues to be controversial. Chemotherapy alone or in combination with radiation continues to be investigated as an adjunct to surgery, along with immunotherapy and targeted therapies. In this review, we discuss the current management of retroperitoneal and pelvis sarcomas, focusing on studies of surgery and radiation therapy to maximize local control.
Topics: Humans; Margins of Excision; Neoplasm Recurrence, Local; Pelvic Neoplasms; Pelvis; Radiotherapy, Adjuvant; Retroperitoneal Neoplasms; Retrospective Studies; Sarcoma
PubMed: 35834940
DOI: 10.1016/j.suronc.2022.101814 -
Current Opinion in Oncology Jul 2002Retroperitoneal soft tissue sarcomas are rare tumors estimated to account for 15%of all patients with soft tissue sarcoma seen in referral populations. The standard of... (Review)
Review
Retroperitoneal soft tissue sarcomas are rare tumors estimated to account for 15%of all patients with soft tissue sarcoma seen in referral populations. The standard of care for patients with localized, resectable retroperitoneal sarcomas is surgical resection with gross and microscopically negative margins. However, owing to the large size and locally advanced nature of these tumors, this goal is difficult to achieve in most patients. As a result, the disease is characterized by a high propensity for local recurrence and a grade-specific risk for distant metastasis. Over the past decade, there has been considerable research into combined modality treatment of these tumors. The present report outlines current concepts relating to the diagnosis, staging, and management of retroperitoneal sarcomas. Emphasis is placed on evolving combined modality treatment approaches and current investigational strategies.
Topics: Chemotherapy, Adjuvant; Combined Modality Therapy; Diagnosis, Differential; Humans; Intraoperative Period; Neoadjuvant Therapy; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasm Staging; Radiotherapy, Adjuvant; Retroperitoneal Neoplasms; Sarcoma
PubMed: 12130924
DOI: 10.1097/00001622-200207000-00006 -
Journal of Surgical Oncology Jul 2006Retroperitoneal sarcomas (RPS) are rare tumors, accounting for approximately 15% of soft tissue sarcomas. Surgical resection of localized tumors with gross and... (Review)
Review
Retroperitoneal sarcomas (RPS) are rare tumors, accounting for approximately 15% of soft tissue sarcomas. Surgical resection of localized tumors with gross and microscopically negative margins remains the standard of care. However, because RPS are frequently large and locally advanced, resections are often incomplete, resulting in local recurrence. Investigators are evaluating combined-modality therapies to improve local control and disease-specific survival. This review outlines current concepts and evolving treatment strategies in the diagnosis, staging, and management of RPS.
Topics: Antineoplastic Combined Chemotherapy Protocols; Biopsy, Needle; Combined Modality Therapy; Drug Administration Schedule; Humans; Intraoperative Care; Leiomyosarcoma; Magnetic Resonance Imaging; Neoplasm Recurrence, Local; Neoplasm Staging; Preoperative Care; Prognosis; Retroperitoneal Neoplasms; Sarcoma; Tomography, X-Ray Computed
PubMed: 16788949
DOI: 10.1002/jso.20543 -
Nihon Rinsho. Japanese Journal of... Jan 1977
Topics: Aged; Female; Fibrosarcoma; Humans; Retroperitoneal Neoplasms
PubMed: 557625
DOI: No ID Found -
Rinsho Byori. the Japanese Journal of... Jan 1970
Topics: Fibrosarcoma; Humans; Male; Middle Aged; Retroperitoneal Neoplasms
PubMed: 5461659
DOI: No ID Found -
European Journal of Gynaecological... 1998A pelvic retroperitoneal schwannoma that was initially thought to be an ovarian neoplasm is reported. The clinicopathologic features of this rare tumor are presented and... (Review)
Review
A pelvic retroperitoneal schwannoma that was initially thought to be an ovarian neoplasm is reported. The clinicopathologic features of this rare tumor are presented and the literature is reviewed.
Topics: Adult; Diagnosis, Differential; Female; Humans; Neurilemmoma; Ovarian Neoplasms; Retroperitoneal Neoplasms
PubMed: 9476061
DOI: No ID Found -
Journal of Surgical Oncology May 2016The multi-modal treatment of retroperitoneal sarcoma has seen increased use of neoadjuvant radiation. However, its effect on local recurrence and survival remain... (Review)
Review
BACKGROUND AND OBJECTIVES
The multi-modal treatment of retroperitoneal sarcoma has seen increased use of neoadjuvant radiation. However, its effect on local recurrence and survival remain controversial. We aimed to synthesize and evaluate the literature.
METHODS
The review was conducted according the recommendation of the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) group with pre-specified inclusion and exclusion criteria.
RESULTS
Of 8,701 citations collected, 15 articles reported on 464 patients. The median age was 56 years (45-64). The predominant histological subtypes were liposarcoma (51.54%) and leiomyosarcoma (23.26%). Tumor differentiation composed of 37.1% well-, 12.8% moderate-, 46.0% poorly-, and 4.1% undifferentiated. Most studies featured external beam radiation therapy (EBRT) treatment regimen with some who included patients treated with IMRT instead. Median follow-up averaged 41.4 months (19-106 months). Median 5-year OS, PFS, and LRR rates were 58%, 71.5%, and 25%. Using the NCI CTCAE, toxicities from Grade 1 (Mild) through Grade 5 (death) were experienced by 18.8%, 10.2%, 16.3%, 0.7%, and 1.6% of patients.
CONCLUSIONS
NART is a safe to use for RPS, but its effect toward survival and local control remains unclear. Without randomized control trials, common reporting criteria for pro- and retrospective studies are needed to allow comparison between studies. J. Surg. Oncol. 2016;113:628-634. © 2016 Wiley Periodicals, Inc.
Topics: Humans; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Radiotherapy, Adjuvant; Retroperitoneal Neoplasms; Sarcoma; Treatment Outcome
PubMed: 26990903
DOI: 10.1002/jso.24221 -
Radiographics : a Review Publication of... 2018Leiomyosarcoma is a malignant neoplasm that shows smooth muscle differentiation. It is the second most common sarcoma to affect the retroperitoneum. Retroperitoneal...
Leiomyosarcoma is a malignant neoplasm that shows smooth muscle differentiation. It is the second most common sarcoma to affect the retroperitoneum. Retroperitoneal leiomyosarcomas may grow to large sizes before detection and may be an incidental finding at imaging. When symptomatic, retroperitoneal leiomyosarcoma may cause compressive symptoms, including pain. Retroperitoneal leiomyosarcoma most commonly manifests as a large soft-tissue mass, with areas of necrosis. The most frequent pattern of growth is an entirely extravascular mass. Less commonly, leiomyosarcoma may demonstrate both extravascular and intravascular components. Rarely, retroperitoneal leiomyosarcomas are completely intravascular, typically arising from the inferior vena cava. Given its variable imaging features, a large variety of neoplastic and nonneoplastic conditions are included in the differential diagnosis of retroperitoneal leiomyosarcoma. In this review, the authors discuss retroperitoneal leiomyosarcoma, with emphasis on the pathologic basis of disease, and illustrate the multimodality imaging appearances of retroperitoneal leiomyosarcoma using cases from the Radiologic Pathology Archives of the American Institute for Radiologic Pathology. The authors review important differential considerations of retroperitoneal leiomyosarcoma, focusing on the extravascular pattern of growth, and emphasize clinical and imaging features that help radiologists differentiate leiomyosarcoma from the most frequent mimics. The information presented in this review will aid radiologists in fulfilling their key roles in the diagnosis, operative planning, and follow-up of patients with retroperitoneal leiomyosarcoma.
Topics: Diagnosis, Differential; Humans; Leiomyosarcoma; Patient Care Planning; Retroperitoneal Neoplasms
PubMed: 30207936
DOI: 10.1148/rg.2018180006 -
Journal of Surgical Oncology Sep 2017
Topics: Humans; Leiomyosarcoma; Neoplasm Recurrence, Local; Patient Selection; Retroperitoneal Neoplasms
PubMed: 28672078
DOI: 10.1002/jso.24745 -
Cancer Control : Journal of the Moffitt... Jul 2011Retroperitoneal sarcomas are rare neoplasms that often present with multivisceral involvement. Treatment for these tumors requires careful decision making requiring a... (Review)
Review
BACKGROUND
Retroperitoneal sarcomas are rare neoplasms that often present with multivisceral involvement. Treatment for these tumors requires careful decision making requiring a combination of surgery, chemotherapy, and radiation therapy.
METHODS
We reviewed the scientific literature pertaining to the diagnosis and management of retroperitoneal sarcomas. We also identify recent developments in treatment and discuss future trends in the care of patients with this disease.
RESULTS
Retroperitoneal tumors often present as large, locally advanced lesions. Evaluation of these tumors requires careful consideration of a multimodality approach. Retrospective data and historical prospective series have demonstrated the survival benefit of radical resection for these tumors with en bloc resection of involved structures. Compartmental resections in the retroperitoneum along with debulking of high-grade disease and regional therapy are controversial approaches with significant morbidity that can lead to long-term survival. The application of neoadjuvant and adjuvant therapies in select tumor histologies may improve local control and survival.
CONCLUSIONS
The management of retroperitoneal sarcomas requires a multidisciplinary approach and is best accomplished at high-volume centers specializing in the care of patients with these complex malignancies. Current data suggest that radical resection remains the only chance for cure and that chemotherapy and radiation therapy may confer a survival benefit.
Topics: Combined Modality Therapy; Disease-Free Survival; Humans; Neoadjuvant Therapy; Neoplasm Metastasis; Neoplasm Recurrence, Local; Patient Care; Prognosis; Retroperitoneal Neoplasms; Sarcoma
PubMed: 21666580
DOI: 10.1177/107327481101800305