Callegaro Dario, Fiore Marco, Gronchi Alessandro
Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian, 1 - 20133 Milan, Italy.
Expert Rev Anticancer Ther. 2015 May;15(5):553-67. doi: 10.1586/14737140.2015.1028375. Epub 2015 Mar 23.
Retroperitoneal sarcomas are a group of diseases that behave differently from one another. Well-differentiated liposarcomas have an indolent biology but show a tendency to recur locally even years after primary resection. Dedifferentiated liposarcomas are characterized by a very high local recurrence risk, while the metastatic risk mainly depends on the histological characteristics of the dedifferentiated component. In leiomyosarcomas, hematogenous spread informs prognosis while local recurrences are far less common. Surgery is the cornerstone of treatment of all retroperitoneal sarcoma subtypes and its quality is the only treatment-related factor able to improve the oncological outcome. A frontline extended surgical approach is all the more critical in subtypes in which local control directly impacts prognosis.
腹膜后肉瘤是一组生物学行为各异的疾病。高分化脂肪肉瘤生物学行为惰性，但即使在初次切除数年之后仍有局部复发倾向。去分化脂肪肉瘤的特点是局部复发风险极高，而转移风险主要取决于去分化成分的组织学特征。在平滑肌肉瘤中，血行转移决定预后，而局部复发则较为少见。手术是所有腹膜后肉瘤亚型治疗的基石，手术质量是唯一能够改善肿瘤治疗结局的治疗相关因素。对于局部控制直接影响预后的亚型，一线扩大手术方式尤为关键。
