Update in Pelvic and Retroperitoneal Sarcoma Management: The Role of Compartment Surgery

Pascual, J M; Hernández, Juan Ángel Fernández; Fernández, Gerardo Blanco; Casares, Cristobal Muñoz; Álvarez, Rosa; Anzorena, Bárbara Fox; Borbalas, Alicia Lozano; Blanco, Manuel Rodríguez; Blázquez, Sonia Cantín; Raventós, Vicente Artigas

doi:10.1016/j.cireng.2019.10.010

Cited by 3 publications

(5 citation statements)

References 45 publications

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“…The importance and indication of LEER surgery in sarcoma is described in the following text. First, R0 en bloc resection is essential for improving prognosis in sarcoma [ 30 , 31 ]. In particular, it is known that sarcomas grow in anatomic compartments and do not easily invade local anatomical boundaries [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of laterally extended endopelvic resection for sarcoma in the female genital tract: a prospective cohort study

Park

Kim

et al. 2022

Obstet Gynecol Sci

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This study aims to evaluate the safety and feasibility of laterally extended endopelvic resection (LEER) for sarcoma in the female genital tract. MethodsWe prospectively recruited gynecologic cancer patients with sarcoma arising from female genital tract who underwent LEER at Seoul National University Hospital from December 2016 to March 2021. Clinicopathologic characteristics, surgical outcomes including postoperative complications and pain control, and survival outcomes of the patients were investigated. ResultsA total of nine patients were registered for this study. The median age was 56 years. Carcinosarcoma (n=2, 22%), leiomyosarcoma (n=2, 22%), and undifferentiated uterine sarcoma (n=2, 22%) were common histology types. Complete resection was achieved in 88.9%. The most common location of pelvic sidewall tumors was infra-iliac acetabulum (66.7%). The pathologic outcome showed a median tumor size of 9.0 cm and internal iliac vessel resection with pelvic sidewall muscle was performed in all patients. The median estimated blood loss was 1,600 mL (range, 300-22,300), and the patients were postoperatively admitted to the intensive care unit (ICU) for median 1 day (range, 0-8). Complete response was observed in 44.4% (4/9) in radiologic studies after LEER, and median progression-free survival, treatment-related survival, and overall survival were 3.3, 19.6, and 98.9 months, respectively. ConclusionLEER was feasible and safe in treating recurrent sarcoma presenting pelvic sidewall invasion with acceptable survival outcomes and manageable postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Safety and feasibility of laterally extended endopelvic resection for sarcoma in the female genital tract: a prospective cohort study

Park

Kim

et al. 2022

Obstet Gynecol Sci

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“…RPS surgery should be performed in referral centers by surgeons experienced in abdominal, retroperitoneal, and pelvic surgery and management of vascular and genitourinary techniques [ 34 , 35 , 36 , 37 ].…”

Section: Treatment Of Resectable Localized Diseasementioning

confidence: 99%

“…Surgical resection should be considered in patients with favorable biology (low grade tumor, low volume in number and size, and long disease-free interval) and when complete resection is expected. Cytoreductive surgery together with intraperitoneal hyperthermic CT (HIPEC) in peritoneal sarcomatosis is associated with high toxicity and no clear benefit, so it is only acceptable within clinical trials [ 36 ].…”

Section: Treatment Of Advanced Diseasementioning

confidence: 99%

“…The use of nomograms as predictive tools for survival and risk of relapse may be useful in adjuvant treatment decision-making and patient selection for clinical trials (III, C). RPS surgery should be performed in referral centers by surgeons experienced in abdominal, retroperitoneal, and pelvic surgery and management of vascular and genitourinary techniques [34][35][36][37].…”

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Updated Review and Clinical Recommendations for the Diagnosis and Treatment of Patients with Retroperitoneal Sarcoma by the Spanish Sarcoma Research Group (GEIS)

Álvarez

Manzano

Pujol

et al. 2023

Cancers

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Soft tissue sarcomas (STS) are an uncommon and biologically heterogeneous group of tumors arising from mesenchymal cells. The incidence is estimated at five cases per 100,000 people per year. Retroperitoneal sarcomas (RPS) account for 10–15% of all STS, and their management depends on their anatomical characteristics and histotype. Due to their very low incidence, it is recommended that RPS be treated in reference centers and evaluated by an experienced multidisciplinary team (MDT). In Spain, the Spanish Group for Research in Sarcomas (GEIS) brings together experts from various specialties to promote research on sarcomas and improve treatment results. This paper summarizes the GEIS recommendations for the diagnosis, treatment, and follow-up of patients with RPS.

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“…This surgical approach, known as frontline extended resection, consists of an en bloc resection of the tumor together with adjacent organs, with the aim of minimizing marginality (R1-2 resections) in the retroperitoneum. This surgical approach has been standardized and is currently the recommended approach by the main groups of experts [ 5 , 6 , 7 , 8 ]. However, in RPS there are multiple prognostic factors such as histologic subtype, tumoral grade, age, or multifocality which can predict the pattern of recurrence and may guide the aggressiveness of the surgery or the need for complementary systemic treatment [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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

Muñoz

Bretcha-Boix

Artigas

et al. 2022

Cancers

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Surgery is the key treatment in retroperitoneal sarcoma (RPS), as completeness of resection is the most important prognostic factor related to treatment. Compartmental surgery/frontline extended approach is based on soft-tissue sarcoma surgical principles, and involves resecting adjacent viscera to achieve a wide negative margin. This extended approach is associated with improved local control and survival. This surgery must be tailored to tumor histology, tumor localization, and patient performance status. We herein present a review of compartmental surgery principles, covering the oncological and technical basis, and describing the tailored approach to each tumor subtype and localization in the retroperitoneum.

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Update in Pelvic and Retroperitoneal Sarcoma Management: The Role of Compartment Surgery

Cited by 3 publications

References 45 publications

Safety and feasibility of laterally extended endopelvic resection for sarcoma in the female genital tract: a prospective cohort study

Safety and feasibility of laterally extended endopelvic resection for sarcoma in the female genital tract: a prospective cohort study

Updated Review and Clinical Recommendations for the Diagnosis and Treatment of Patients with Retroperitoneal Sarcoma by the Spanish Sarcoma Research Group (GEIS)

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

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