Retroperitoneal Sarcomas: a Current Review on Management

Overview

Journal Indian J Surg Oncol

Specialty Oncology

Date 2022 Oct 3

PMID 36187536

Authors

Shraddha Patkar

Abhay K Kattepur

Nehal Khanna

Jyoti Bajpai

Affiliations

Soon will be listed here.

Abstract

Retroperitoneal sarcomas are heterogeneous tumours with variable disease biology and outcomes. The prognosis is primarily related to tumour histology and grade as well as the ability to achieve margin negative resection. Surgery involves compartment or contiguous organ resection to achieve the above goal. Careful utilization of neoadjuvant and adjuvant strategies like radiotherapy and/or chemotherapy can lead to improvement in margin status, thereby contributing to better local control and possibly reducing systemic dissemination. Use of targeted therapies has paved newer pathways of treatment integration centred on molecular and genetic targets. The aim of this review is to update the reader on all aspects of retroperitoneal sarcoma management including emphasis on pertinent and landmark trials in this regard.

Citing Articles

Case Report: Successful R0 resection in locally advanced retroperitoneal sarcomas.

Bael P, Alqtishat B, Alshawwa K Front Surg. 2024; 11:1343014.

PMID: 38317853 PMC: 10839003. DOI: 10.3389/fsurg.2024.1343014.

References

Wong P, Kassam Z, Springer A, Gladdy R, Chung P, Ringash J . Long-Term Quality of Life of Retroperitoneal Sarcoma Patients Treated with Pre-Operative Radiotherapy and Surgery. Cureus. 2017; 9(10):e1764. PMC: 5724811. DOI: 10.7759/cureus.1764. View

Ng D, Swallow C . Decision-making for palliative versus curative intent treatment of retroperitoneal sarcoma (RPS). Chin Clin Oncol. 2018; 7(4):40. DOI: 10.21037/cco.2018.08.05. View

Italiano A, Delva F, Mathoulin-Pelissier S, Le Cesne A, Bonvalot S, Terrier P . Effect of adjuvant chemotherapy on survival in FNCLCC grade 3 soft tissue sarcomas: a multivariate analysis of the French Sarcoma Group Database. Ann Oncol. 2010; 21(12):2436-2441. DOI: 10.1093/annonc/mdq238. View

Pervaiz N, Colterjohn N, Farrokhyar F, Tozer R, Figueredo A, Ghert M . A systematic meta-analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable soft-tissue sarcoma. Cancer. 2008; 113(3):573-81. DOI: 10.1002/cncr.23592. View

Gronchi A, Crago A, Raut C . Minimally Invasive Surgery for Retroperitoneal Sarcoma: Just Because We Can Does Not Mean We Should. Ann Surg Oncol. 2018; 25(8):2129-2131. DOI: 10.1245/s10434-018-6572-9. View

Gronchi A, Miceli R, Shurell E, Eilber F, Eilber F, Anaya D . Outcome prediction in primary resected retroperitoneal soft tissue sarcoma: histology-specific overall survival and disease-free survival nomograms built on major sarcoma center data sets. J Clin Oncol. 2013; 31(13):1649-55. DOI: 10.1200/JCO.2012.44.3747. View

Ng D, Tan G, Chia C, Chee S, Quek R, Farid M . Tumor biology remains the main determinant of prognosis in retroperitoneal sarcomas: a 14-year single-center experience. Asia Pac J Clin Oncol. 2017; 13(5):e458-e465. DOI: 10.1111/ajco.12662. View

Gronchi A, Lo Vullo S, Fiore M, Mussi C, Stacchiotti S, Collini P . Aggressive surgical policies in a retrospectively reviewed single-institution case series of retroperitoneal soft tissue sarcoma patients. J Clin Oncol. 2008; 27(1):24-30. DOI: 10.1200/JCO.2008.17.8871. View

Gieschen H, Spiro I, Suit H, Ott M, Rattner D, Ancukiewicz M . Long-term results of intraoperative electron beam radiotherapy for primary and recurrent retroperitoneal soft tissue sarcoma. Int J Radiat Oncol Biol Phys. 2001; 50(1):127-31. DOI: 10.1016/s0360-3016(00)01589-3. View

10.

Roeder F, Ulrich A, Habl G, Uhl M, Saleh-Ebrahimi L, Huber P . Clinical phase I/II trial to investigate preoperative dose-escalated intensity-modulated radiation therapy (IMRT) and intraoperative radiation therapy (IORT) in patients with retroperitoneal soft tissue sarcoma: interim analysis. BMC Cancer. 2014; 14:617. PMC: 4156610. DOI: 10.1186/1471-2407-14-617. View

11.

Zerhouni S, Van Coevorden F, Swallow C . The role and outcomes of palliative surgery for retroperitoneal sarcoma. J Surg Oncol. 2017; 117(1):105-110. DOI: 10.1002/jso.24934. View

12.

van Houdt W, Raut C, Bonvalot S, Swallow C, Haas R, Gronchi A . New research strategies in retroperitoneal sarcoma. The case of TARPSWG, STRASS and RESAR: making progress through collaboration. Curr Opin Oncol. 2019; 31(4):310-316. DOI: 10.1097/CCO.0000000000000535. View

13.

Alektiar K, Hu K, Anderson L, Brennan M, Harrison L . High-dose-rate intraoperative radiation therapy (HDR-IORT) for retroperitoneal sarcomas. Int J Radiat Oncol Biol Phys. 2000; 47(1):157-63. DOI: 10.1016/s0360-3016(99)00546-5. View

14.

Petrou A, Constantinidou A, Kontos M, Papalampros A, Moris D, Bakoyiannis C . Comprehensive Surgical Treatment as the Mainstay of Management in Retroperitoneal Sarcomas: Retrospective Study from Two Non-sarcoma Specialist Centers. Anticancer Res. 2017; 37(4):2025-2031. DOI: 10.21873/anticanres.11547. View

15.

Bajpai J, Susan D . Adjuvant chemotherapy in soft tissue sarcomas…Conflicts, consensus, and controversies. South Asian J Cancer. 2016; 5(1):15-9. PMC: 4845599. DOI: 10.4103/2278-330X.179687. View

16.

Bagaria S, Neville M, Gray R, Gabriel E, Ashman J, Attia S . The Volume-Outcome Relationship in Retroperitoneal Soft Tissue Sarcoma: Evidence of Improved Short- and Long-Term Outcomes at High-Volume Institutions. Sarcoma. 2018; 2018:3056562. PMC: 6081523. DOI: 10.1155/2018/3056562. View

17.

MacNeill A, Miceli R, Strauss D, Bonvalot S, Hohenberger P, Van Coevorden F . Post-relapse outcomes after primary extended resection of retroperitoneal sarcoma: A report from the Trans-Atlantic RPS Working Group. Cancer. 2017; 123(11):1971-1978. DOI: 10.1002/cncr.30572. View

18.

De Sanctis R, Giordano L, Colombo C, De Paoli A, Navarria P, Sangalli C . Long-term Follow-up and Post-relapse Outcome of Patients with Localized Retroperitoneal Sarcoma Treated in the Italian Sarcoma Group-Soft Tissue Sarcoma (ISG-STS) Protocol 0303. Ann Surg Oncol. 2017; 24(13):3872-3879. DOI: 10.1245/s10434-017-6105-y. View

19.

Ecker B, Peters M, McMillan M, Sinnamon A, Zhang P, Fraker D . Preoperative radiotherapy in the management of retroperitoneal liposarcoma. Br J Surg. 2016; 103(13):1839-1846. DOI: 10.1002/bjs.10305. View

20.

Wang J, Grignol V, Gronchi A, Luo C, Pollock R, Tseng W . Surgical management of retroperitoneal sarcoma and opportunities for global collaboration. Chin Clin Oncol. 2018; 7(4):39. DOI: 10.21037/cco.2018.07.05. View