Update in pelvic and retroperitoneal sarcoma management: The role of compartment surgery

Cir Esp (Engl Ed). 2019 Nov;97(9):480-488. doi: 10.1016/j.ciresp.2019.06.011. Epub 2019 Sep 12.
[Article in English, Spanish]

Abstract

Surgery for retroperitoneal sarcomas should be "en bloc" compartmental, which involves resection of unaffected organs. Its upfront use is key, providing a high percentage of resections with negative margins, resulting in a better local control and increased survival in many patients. Preservation of organs should be done in an individualized manner, especially in the pelvic location, and adapted to the histological aggressiveness of the tumor. Preoperative biopsy is able to establish the diagnosis of sarcoma subtype and consequently an adequate perioperative strategy. These patients should be managed by expert surgeons at referral centers with multidisciplinary units and oncology committees. The use of chemotherapy and radiotherapy is not yet well defined, so it is only recommended at referral centers with clinical trials. Currently, this is the only option to offer the best morbidity and mortality rates, as well as possible improvements in the survival of these patients.

Keywords: Chemotherapy; Cirugía compartimental; Compartment surgery; Multidisciplinary therapy; Quimioterapia; Radioterapia; Radiotherapy; Retroperitoneo; Retroperitoneum; Sarcoma; Tratamiento multidisciplinar.

MeSH terms

  • Biopsy
  • Drug Therapy / methods
  • Drug Therapy / standards
  • Humans
  • Margins of Excision
  • Neoplasm Recurrence, Local / surgery
  • Patient Care Team / organization & administration*
  • Pelvic Neoplasms / epidemiology
  • Pelvic Neoplasms / pathology
  • Pelvic Neoplasms / therapy*
  • Preoperative Period
  • Prognosis
  • Radiotherapy / methods
  • Radiotherapy / standards
  • Retroperitoneal Neoplasms / epidemiology
  • Retroperitoneal Neoplasms / pathology
  • Retroperitoneal Neoplasms / therapy*
  • Sarcoma / epidemiology
  • Sarcoma / mortality
  • Sarcoma / surgery*
  • Surgeons
  • Survival Rate