Surgical Principles of Primary Retroperitoneal Sarcoma in the Era of Personalized Treatment: A Review of the Frontline Extended Surgery

Muñoz, Paula; Bretcha-Boix, Pedro; Artigas, V. Hosp. Santa Cruz y S. Pablo de Barcelona; Asencio, José Manuel

doi:10.3390/cancers14174091

Cited by 11 publications

(4 citation statements)

References 73 publications

(116 reference statements)

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“…In systemic therapy, there are molecular therapies and new synthetic agents such as marine derived synthetics, Eribulin mesylate and trabectedin (3,16). In the field of surgical oncology, compartmental surgery is also being explored (17). In radiation oncology, off-trial results regarding STS treatments are given more attention (18).…”

Section: Discussionmentioning

confidence: 99%

Case report and literature review: Conversion surgery for initially unresectable huge retroperitoneal liposarcoma after preoperative radiotherapy

et al. 2023

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BackgroundRetroperitoneal liposarcoma (RPLS) is a rare malignancy that is notorious for recurrence. Surgical resection with clean margin is the current treatment of choice. However, owing to the large retroperitoneal space, RPLSs often grow to significant sizes before being diagnosed. Neoadjuvant and adjuvant therapies have potentials to improve long term treatment outcome.Case presentationA 55-year-old Han Chinese male presented to the general surgery department with a one-year history of abdominal fullness and a one-week history of palpable right inguinal mass. At first, he was diagnosed with incarcerated inguinal hernia. However, abdominal computer tomography (CT) and biopsy confirmed his final diagnosis to be retroperitoneal well-differentiated liposarcoma, cT2bN0M0, stage IIb. The tumor, which measured 44.5cm in maximum diameter, was too large for primary surgical resection. Neoadjuvant radiotherapy with 70 Gy in 35 fractions was delivered to the tumor, which shrunk the target volume from 6300 cc to 4800 cc, as observed in the middle of the radiotherapy course. The right testicular mass also received 70Gy/35Fx. Conversion surgery was performed after radiotherapy. Unfortunately, due to residual tumor, adjuvant chemotherapy consisting of AIM (ifosfamide, Mesna, and doxorubicin) and MAID (Mesna, doxorubincin, ifosfamide, and dacarbazine) regimens were administered sequentially. Afterward, debulking surgery was conducted, plus another 18 cycles of ifosfamide monotherapy when residual tumor was still seen on CT. Since the completion of ifosfamide chemotherapy, the patient has been cancer free with no evidence of tumor recurrence for more than 26 months.ConclusionDespite conflicting evidence in the literature, our case supports the use of high dose neoadjuvant radiotherapy and adjuvant chemotherapy in treating large, unresectable RPLSs. It also highlights the importance of using individualized, multidisciplinary approach in achieving cure for large, unresectable rare tumors.

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Section: Discussionmentioning

confidence: 99%

Case report and literature review: Conversion surgery for initially unresectable huge retroperitoneal liposarcoma after preoperative radiotherapy

et al. 2023

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“…Careful planning within a multidisciplinary framework is imperative for surgical procedures, considering factors such as tumor stage and size, patient age, and comorbidities. Standardizing the surgical approach is crucial to maximize the chances of achieving complete R0 resections with negative microscopic margins [ 18 ]. In our case, the Multidisciplinary Team opted against preoperative neoadjuvant treatment, opting instead for surgery, pending reassessment after the histopathological report.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal liposarcoma: unveiling diagnostic delays and multimodal treatment dilemmas

Vlasceanu,

Soroceanu,

Timofte

2023

Arch Clin Cases

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Liposarcomas are a prevalent subtype of soft tissue sarcomas, constituting less than 1% of all malignancies. Originating in the adipose tissue, they can manifest in various locations and are categorized by the World Health Organization into several subtypes: well-differentiated liposarcomas, dedifferentiated liposarcomas, myxoid liposarcomas, pleomorphic liposarcomas and mixed-type liposarcomas . These tumors typically affect middle-aged and older individuals, and their incidence has been progressively increasing over the years. As liposarcomas advance they tend to encase blood vessels and major organs, particularly in the retroperitoneal area. Often asymptomatic initially, symptoms arise as the tumor reaches a considerable size, exerting pressure on adjacent tissues and organs. This report features a 54-year-old patient incidentally diagnosed with a substantial retroperitoneal tumor extending to the antero-lateral abdominal wall and inner thigh via the right inguinal ligament. The patient, with a previous three-year history of a right inguinal mass, sought acute care for a perianal abscess The histological examination revealed morphological aspects consistent with a low-grade myxoid liposarcoma. While surgery remains the primary treatment for retroperitoneal liposarcomas, controversies exist regarding the role of radiotherapy and chemotherapy in improving survival rates. This case highlights the challenges in managing retroperitoneal tumors and underscores the importance of a personalized, multidisciplinary approach to optimize patient outcomes.

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“…For the treatment of RPLS, radical surgical resection is the first choice and is the only possible cure at present. In order to achieve therapeutic effects, while ensuring safety, as much of the tumor should be removed as possible ( 20 ). In cases of malignant invasion of RPLS, complete resection is often combined with removal of the adjacent organs that may be affected, such as the kidney, spleen and gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

Survival of a patient with five recurrences of retroperitoneal liposarcoma over a period of 13 years: A case report and review

2023

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Retroperitoneal liposarcoma (RPLS) is a rare tumor that occurs in the retroperitoneal region and accounts for ~0.2% of all malignant tumor incidence. The present study describes the treatment of a surviving patient with RPLS that recurred five times in 13 years. This case has a long survival time and numerous relapses, which is a rare occurrence. The 40-year-old female patient was admitted to Shaoxing Second Hospital (Shaoxing, China) with an abdominal mass. Abdominal computed tomography (CT) scan revealed multiple liposarcoma recurrences in the abdominal, pelvic and retroperitoneal areas. As the diagnosis of RPLS was the fifth recurrence, cytoreductive surgery was performed and post-operative pathology suggested mixed liposarcoma. The patient underwent six cycles of doxorubicin and ifosfamide regimen chemotherapy and targeted therapy with anlotinib following surgery; no evidence of disease progression was found on abdominal CT scan during follow-up. The present study also reviewed the literature in terms of the clinical diagnosis, treatment, pathological characteristics and similar cases of liposarcoma with the aim of improving diagnosis and treatment.

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Surgical Principles of Primary Retroperitoneal Sarcoma in the Era of Personalized Treatment: A Review of the Frontline Extended Surgery

Cited by 11 publications

References 73 publications

Case report and literature review: Conversion surgery for initially unresectable huge retroperitoneal liposarcoma after preoperative radiotherapy

Case report and literature review: Conversion surgery for initially unresectable huge retroperitoneal liposarcoma after preoperative radiotherapy

Retroperitoneal liposarcoma: unveiling diagnostic delays and multimodal treatment dilemmas

Survival of a patient with five recurrences of retroperitoneal liposarcoma over a period of 13 years: A case report and review

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