Personalizing the Approach to Retroperitoneal Soft Tissue Sarcoma: Histology-specific Patterns of Failure and Postrelapse Outcome after Primary Extended Resection

Gronchi, Alessandro; Miceli, Rosalba; Allard, Marc Antoine; Callegaro, Dario; Péchoux, C. Le; Fiore, Marco; Honoré, Charles; Sanfilippo, Roberta; Coppola, Sara; Stacchiotti, Silvia; Terrier, Philippe; Casali, Paolo G.; Cesne, Axel Le; Mariani, Luigi; Colombo, Chiara; Bonvalot, Sylvie

doi:10.1245/s10434-014-4130-7

Cited by 159 publications

(150 citation statements)

References 26 publications

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“…12 Follow-up analysis of the same series, however, reported a 66% overall survival rate among the extended surgical resection cohort compared with a 48% overall survival rate in historic controls. [13][14][15][16] A major limitation of this approach, beyond the nonrandomized nature of the data, is the morbidity associated with the operation. In a series of 249 patients, 30% required a reoperation or invasive procedure for a complication related to surgery, and 3% of patients died of postoperative complications.…”

Section: 3mentioning

confidence: 99%

Local Control of Soft Tissue and Bone Sarcomas

Crompton

Bernthal²,

Kawai³

et al. 2018

JCO

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Sarcomas of soft tissue and bone are mesenchymal malignancies that can arise in any anatomic location, most commonly the extremity, retroperitoneum, and trunk. Even for lower grade histologic subtypes, local recurrence can cause significant morbidity and even disease-related death. Although surgery remains the cornerstone of local control, perioperative radiation and systemic therapy are often important adjuvants. This review will summarize the current therapeutic approaches for local control of soft tissue and bone sarcomas.J Clin Oncol 35.

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Section: 3mentioning

confidence: 99%

Local Control of Soft Tissue and Bone Sarcomas

Crompton

Bernthal²,

Kawai³

et al. 2018

JCO

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“…Factors reportedly associated with a longer survival after salvage surgery for RP sarcomas in general are a long recurrence-free interval, 11 unifocal disease, 12 and complete resection. 7 Park et al reported that a slow tumor growth rate after recurrence (<0.9 cm/month) was predictive for longer disease-free survival (DFS) in recurrent RP liposarcomas.…”

Section: Introductionmentioning

confidence: 99%

Salvage Surgery for Recurrent Retroperitoneal Well-Differentiated Liposarcoma: Early Reoperation may not Provide Benefit

et al. 2018

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Purpose Current evidence regarding salvage resection for recurrent retroperitoneal (RP) sarcomas generally lacks detailed histology-specific analyses, but the aggressiveness of these tumors varies widely by histology. We investigated associations between timing and extent of salvage surgery and survival outcomes in patients with recurrent RP well-differentiated liposarcoma (WDLPS). Methods The University of Texas MD Anderson Cancer Center Surgical Oncology sarcoma database was reviewed to identify patients with RP WDLPS who underwent surgical resection for 1st recurrent disease (salvage surgery) in 1995–2015. Medical records were retrospectively reviewed to identify factors associated with overall survival (OS) and disease-free survival (DFS). Results We identified 52 patients who underwent salvage surgery for RP WDLPS for 1st local recurrence; 28 (54%) underwent salvage surgery within 6 months after recurrence. Concomitant organ resections were performed in 32 (62%) patients, 4 (13%) of whom had pathologic invasion of resected organs. After R0/R1 resections (n=45), 38 (84%) experienced a 2nd local recurrence. Multivariable analyses revealed that organ invasion at the primary surgery (HR 13.08; p=0.005) and disease-free interval <1 year (HR 3.64; p=0.044) were associated with shorter OS. Recurrence-to-salvage interval <6 months was associated with shorter DFS (HR 2.18; p=0.025). Concomitant organ resection was associated with a longer hospital stay, ≥14 days (OR 21.58; p=0.007). Conclusions Early salvage surgery may not always be the best approach for recurrent RP WDLPS patients. Since organ invasion is rare among recurrent RP WDLPS patients and concomitant organ resection is associated with a longer hospital stay, preservation of uninvolved organs should be considered.

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“…Le caractère monobloc n'est pas suffisant : les organes inclus dans la tumeur doivent être réséqués, et on effectue éventuellement l'ablation de viscères adjacents (côlon le plus souvent), d'une part pour optimiser les marges, d'autre part afin d'éviter de rompre la tumeur en passant au ras, ce qui est un risque classique dans les sarcomes de haut grade. Bien entendu, on pondère en fonction de l'histologie [16] du viscère concerné, de la morbidité attendue en fonction du cumul des exérèses à faire et des comorbidités, et de l'âge du patient [17]. Les vaisseaux et les nerfs ne sont pas réséqués s'ils ne sont pas infiltrés.…”

Section: Paramètres D'évaluationunclassified

Les critères de qualité de la prise en charge chirurgicale des sarcomes des tissus mous

et al. 2016

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Il existe un gros levier d'amélioration possible dans la prise en charge des sarcomes de tissus mous, en particulier au moment de la chirurgie, à un stade où le patient est potentiellement curable. En effet, une étude du Groupe sarcome français a montré que la chirurgie est inadaptée dans plus de la moitié des cas. Il faut savoir penser à un sarcome avant tout geste, suivre les recommandations et surtout adresser les patients dans un centre entraîné à cette chirurgie. L'évalua-tion des résultats de la chirurgie serait un paramètre important d'amélioration continue, qui pourra être disponible grâce aux bases de données nationales. Mots clés Sarcomes · Tissus mous · Qualité · Chirurgie · RéseauxAbstract Improvements in the treatment of soft tissue sarcomas should be achieved, particularly at the time of surgery, when the patient is curable. However, surgery is inadequate in more than half of the cases. It is fundamental to think about sarcoma before any surgery, follow the guidelines and refer the patients to a specialized center. Surgical results would be an important parameter of continuous improvement, which will be available through national databases.

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Personalizing the Approach to Retroperitoneal Soft Tissue Sarcoma: Histology-specific Patterns of Failure and Postrelapse Outcome after Primary Extended Resection

Abstract: When primary extended surgery limits LR, histologic subtype and grade determine the outcome. At recurrence, a second surgery is of limited benefit.

Cited by 159 publications

References 26 publications

Local Control of Soft Tissue and Bone Sarcomas

Local Control of Soft Tissue and Bone Sarcomas

Salvage Surgery for Recurrent Retroperitoneal Well-Differentiated Liposarcoma: Early Reoperation may not Provide Benefit

Les critères de qualité de la prise en charge chirurgicale des sarcomes des tissus mous

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