Retroperitoneal sarcomas: Combined-modality treatment approaches

Abstract

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.

Morbidity and Functional Status of Patients With Pelvic Neurogenic Tumors After Wide Excision

“…This is consistent with the 20% to 66% incidence of complications reported in the literature for surgical resection of malignant tumors of the retrorectal space [4,13,17,19]. Complications were more common after surgical treatment for malignant disease (six of 12) compared to benign lesions (three of 26).…”

Surgical Approach and Oncologic Outcomes Following Multidisciplinary Management of Retrorectal Sarcomas

“…However, given that improved survival in patients with soft-tissue sarcomas, especially those with high-grade lesions, has been limited by high rates of local and distant relapse, and aggressive multimodality approach seem warranted. 15 Significant postoperative complications in our series were mainly related to infection (wound infection, intraabdominal abscess) and wound healing. These occurred more commonly in patients undergoing major bony resection.…”

“…16,17 Similar findings using chemotherapy alone, or in combination with radiation, have been seen for extremity and retroperitoneal soft tissue sarcomas, resulting in decreased local and distant relapse with trends toward improved survival. 15,18,19 With the small numbers in our series, meaningful conclusions as to the utility of adjuvant therapy in this surgical setting cannot be drawn. However, given that improved survival in patients with soft-tissue sarcomas, especially those with high-grade lesions, has been limited by high rates of local and distant relapse, and aggressive multimodality approach seem warranted.…”

“…Adjuvant therapy used in our patients followed protocols typically for soft-tissue sarcomas. 15 In our series, postoperative radiation was given to patients who did not receive it preoperatively and had less than 2-cm margins. Postoperative chemotherapy was given to patients with large ([5 cm) high-grade tumors.…”

Retroperitoneal Sarcomas- A Challenging Problem

“…The most common presentation is an asymptomatic abdominal mass [2]. They are usually asymptomatic, but may present with pain, early satiety, symptoms of bowel obstruction, neurologic symptoms of pain radiating to lower limb or ipsilateral lower limb oedema [1,2,5]. They may also be diagnosed incidentally.…”