Surgical Management of Retroperitoneal Sarcoma

Abstract

Surgery is the cornerstone of treatment for retroperitoneal sarcoma (RPS). Surgery should be performed by a surgical oncologist with sub-specialization in this disease and in the context of a multidisciplinary team of sarcoma specialists. For primary RPS, the goal of surgery is to achieve the complete en bloc resection of the tumor along with involved organs and structures to maximize the clearance of the disease. The extent of resection also needs to consider the risk of complications. Unfortunately, the overarching challenge in primary RPS treatment is that even with optimal surgery, tumor recurrence occurs frequently. The pattern of recurrence after surgery (e.g., local versus distant) is strongly associated with the specific histologic type of RPS. Radiation and systemic therapy may improve outcomes in RPS and there is emerging data studying the benefit of non-surgical treatments in primary disease. Topics in need of further investigation include criteria for unresectability and management of locally recurrent disease. Moving forward, global collaboration among RPS specialists will be key for continuing to advance our understanding of this disease and find more effective treatments.

Metastatic Retroperitoneal Leiomyosarcoma: Case Report

“…Surgical resection with tumor-free margins is considered the primary treatment for retroperitoneal sarcomas 11 , but due to the usually late diagnosis with tumor invasion into adjacent structures, this treatment can lead to recurrences, a common cause of mortality 3 . Thus, en bloc resection of adjacent organs is the recommended therapy according to the guidelines of the European Society for Medical Oncology for better prognosis 11 .…”

Retroperitoneal leiomyosarcoma mimicking an ovarian tumor diagnosed using a negative ovarian pedicle sign

“…Usually found as a large abdominal mass as the tumor enlarges without clinical symptoms, LMS may occasionally be accompanied by symptoms such as abdominal pain and distention [ 4 ]. Preoperative imaging plays an important role in estimating the organ of origin, the tumor component, tumor extent, absence or presence of enlarged lymph nodes, and distant metastases [ 8 ]. The first-line treatment for RPLMS is surgical resection with negative margins.…”

Uterine leiomyosarcoma metastatic to the pancreas

“…The patient was offered adjuvant doxorubicin chemotherapy but refused treatment. Radical surgery is recommended to treat retroperitoneal sarcomas, and complete cross resection is associated with improved survival [1,2]. Adjuvant therapy typically involves doxorubicin or ifosfamide chemotherapy [2].…”