Surgical management of primary and recurrent soft tissue sarcomas of the retroperitoneum

Bonvalot, S.; Dubé, Pierre; Cesne, Axel Le; Elias, Damian O.; Terrier, P.; Vanel, D.; Lasser, P; Genin, J

doi:10.1016/s0959-8049(97)84976-3

Cited by 4 publications

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“…Since failure of retroperitoneal sarcoma treatment is usually associated with local recurrence, and less frequently distant metastases (3,8,10,20,23), the surgical margin seems to be the most important prognostic factor. Radiotherapy might reduce the recurrence rate and improve overall survival.…”

Section: Discussionmentioning

confidence: 99%

Value of Combined Treatment of Retroperitoneal Sarcomas

Kamiński

Kołosza

Strojek

et al. 2007

Polish Journal of Surgery

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The aim of the study was to determine treatment results in patients with retroperitoneal sarcomas, especially as respects the value of combined therapy. Material and methods. The study group included 37 patients with retroperitoneal sarcomas who underwent treatment at the Department of Oncological Surgery, Oncology Center in Gliwice during the period between 1992 and 2005. The study group included 25 women and 12 men, aged between 21 and 68 years (mean age -56.2 years). Adjuvant therapy after the operation was performed in the case of 15 patients. Nine received adjuvant teleradiotherapy (RT) at an average dose of 47.5 Gy (one patient after a non-resective procedure). Four received intraoperative brachytherapy (BT) at a dose of 15.8 Gy in combination with postoperative teleradiotherapy at a dose of 39 Gy. One patient was subjected to intraoperative brachytherapy. One female patient received adjuvant chemotherapy (Iphosphamid + Adriamycin). Results. The cumulative five-year total survival period of the analysed group was 40.7% according to Kaplan-Meier's method. Twenty patients died and four were diagnosed with recurrence, while 13 continue to live without recurrence. The type of resection had a significant effect on total survival (p=0.013): the five-year survival after radical procedures was 52.1%. We observed no five-year survivals after nonradical procedures. In order to determine the efficacy of combined treatment, patients who underwent to radical therapy were divided into three groups: patients without adjuvant therapy (group 1: 22 patients, 62.9%), patients subjected to adjuvant RT and BT therapy after the primary operation (group II: 5 patients, 14.25%), and patients who underwent the above-mentioned treatments after surgery, due to recurrence (group III: 8 patients, 22.85%). The total five-year survival in group I was 34.8%, in group II, 80%, and in group III, 72.9%. These differences were statistically insignificant (p=0.440). These results were probably influenced by the small number of patients, considering particular groups. Conclusions. 1. The most important prognostic factor in the treatment of retroperitoneal sarcomas is surgical margine type surgical margin. 2. Adjuvant radiotherapy, especially in combination with intraoperative brachytherapy, seems to be a promising method for the management of retroperitoneal sarcomas, and improves treatment results. 3. Treatment of retroperitoneal sarcomas should be undertaken in specialized centers adequately prepared for combined therapy. Key words: retroperitoneal sarcomas, adjuvant radiotherapy, intraoperative brachytherapy, combined therapy of neoplasms POLSKI PRZEGLĄD CHIRURGICZNY 10.2478/v10035-007-0045-3 2007 Retroperitoneal sarcomas are rarely diagnosed and account for only 10-15% of all soft tissue sarcomas, which in turn constitute 1% of all malignant neoplasms. They most often develop after the age of 50 years, and occur with similar frequency in men and women. Based

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Section: Discussionmentioning

confidence: 99%

Value of Combined Treatment of Retroperitoneal Sarcomas

Kamiński

Kołosza

Strojek

et al. 2007

Polish Journal of Surgery

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“…In this respect, it is at present unclear whether earlier detection of recurrence by a policy of intensive follow up in RPS facilitates resection of local recurrences or merely adds lead‐time bias to post‐recurrence survival, particularly because there is no uniform classification of palliative procedures carried out for RPS 24 . What is clear is that local recurrence of RPS is the main determinant of tumour‐related mortality because it may progress in the absence of distant metastatic disease.…”

Section: Discussionmentioning

confidence: 99%

“…This result was confirmed in our patients for en bloc nephrectomy that is commonly carried out in RPS but where the kidney often has no direct histological infiltration, a result previously reported by Russo et al 23 In this respect, it is at present unclear whether earlier detection of recurrence by a policy of intensive follow up in RPS facilitates resection of local recurrences or merely adds lead-time bias to post-recurrence survival, particularly because there is no uniform classification of palliative procedures carried out for RPS. 24 What is clear is that local recurrence of RPS is the main determinant of tumour-related mortality because it may progress in the absence of distant metastatic disease. It is more likely to occur with initially higher grade tumours 25 and its presence has a strong negative effect on cancer-specific survival 26 although it may be successfully treated by repeat resection (as in our study) if it is unifocal and can be completely reresected.…”

Section: Discussionmentioning

confidence: 99%

Effect of Resection and Outcome in Patients With Retroperitoneal Sarcoma

Chiappa

Zbar

Biffi

et al. 2006

ANZ Journal of Surgery

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“…Nous nous intéressons plus particulièrement à la prise en charge des tumeurs les plus fréquemment retrouvées dans cette localisation, soit les sarcomes. Les principales molécules actives pour les tumeurs sarcomateuses sont la doxorubicine à la dose optimale de 50 mg/m 2 aux3 semaines (taux de réponse de 20 à 35 %) et l'ifosfamide (taux de réponse de 20 à 40 %) 22 . La chimiothérapie peut être indiquée en situation néoadju-vante, adjuvante, et bien entendu, en cas de récidive locale, le plus souvent isolée et responsable de la plupart des décès des patients 22 .…”

Section: Tumeurs Rétropéritonéales Primitivesunclassified

“…Les principales molécules actives pour les tumeurs sarcomateuses sont la doxorubicine à la dose optimale de 50 mg/m 2 aux3 semaines (taux de réponse de 20 à 35 %) et l'ifosfamide (taux de réponse de 20 à 40 %) 22 . La chimiothérapie peut être indiquée en situation néoadju-vante, adjuvante, et bien entendu, en cas de récidive locale, le plus souvent isolée et responsable de la plupart des décès des patients 22 . La surveillance de ces patients est d'abord clinique par la palpation abdominale et les touchers pelviens à la recherche de sarcomatose.…”

Section: Tumeurs Rétropéritonéales Primitivesunclassified

Tumeurs rétropéritonéales primitives : Profils diagnostique, thérapeutique et anatomopathologique

Aitsakel

Elsayegh

Benslimane

et al. 2015

CUAJ

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RésuméIntroduction : Les tumeurs rétropéritonéales forment un groupe hétérogène de tumeurs rares (< 1 % de toutes les tumeurs), dont 80 % sont malignes. Leur identification et la connaissance de leur pronostic sont les conditions essentielles à leur prise en charge thérapeutique. Le diagnostic positif était fait par TDM abdomino-pelvienne. Le traitement était surtout chirurgical, visant l'exérèse complète de la masse tumorale, avec ou sans thérapie adjuvante (radiothérapie, chimiothérapie) selon l'analyse histologique. Les tumeurs mésoder-miques sont les plus fréquentes (63,6 % ; n = 5) : deux liposarcomes (18 %), deux lymphomes malins (18 %), un hémangiopéricytome (9 %), un léiomyosarcome (9 %), et un cas de rhabdomyosarcome (9 %). Le taux de tumeurs ectodermiques était de 27,4 % (n = 3) ; il s'agit de deux cas de schwannome (18 %) et un cas de ganglioneuroblastome (9 %). Aucune tumeur vestigiale, contre un cas de tumeur pseudo-inflammatoire (9 %). Une évolution favorable a été obervée chez près de la moitié des patients (40 %); on a noté quatre cas de récidive, trois cas de patients perdus de vue, et un décès. Conclusion : Dans notre série, les tumeurs mésodermiques malignes restent les plus fréquentes, sans prédominance d'âge et de sexe. Les tumeurs rétropéritonéales gardent un pronostic sombre, étant donné que nos patients sont vus à un stade tardif, et aussi du fait du potentiel malin et récidivant de ces tumeurs.

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Surgical management of primary and recurrent soft tissue sarcomas of the retroperitoneum

Cited by 4 publications

References 0 publications

Value of Combined Treatment of Retroperitoneal Sarcomas

Value of Combined Treatment of Retroperitoneal Sarcomas

Effect of Resection and Outcome in Patients With Retroperitoneal Sarcoma

Tumeurs rétropéritonéales primitives : Profils diagnostique, thérapeutique et anatomopathologique

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