Murez T, Fléchon A, Rocher L, Camparo P, Morel-Journel N, Savoie P-H, Ferretti L, Sèbe P, Méjean A, Durand X
Comité de cancérologie de l'Association française d'urologie, groupe Organes génitaux externes, maison de l'urologie, 11rue Viète, 75017 Paris, France.
Prog Urol. 2016 Nov;27 Suppl 1:S183-S190. doi: 10.1016/S1166-7087(16)30708-4.
The purpose of this article was established by the external genitalia group CCAFU recommandations for diagnosis, treatment and monitoring of retroperitoneal sarcomas, intended for urologists.
The multidisciplinary working group has updated the 2013 guidelines, based on an exhaustive review of the literature on PubMed, valued references, level of evidence, to assign grades of recommendation.
From a clinical suspicion evoking a RPS, computed tomography thoraco abdominal and pelvic is the gold standard. MRI is useful for surgical planning. Before the biopsy confirmation, the inclusion of the file in the French sarcoma pathology reference network should be the rule. The biopsy under scanner performed by retroperitoneal approach is recommended and should be achieve before any therapeutic management of a suspicious retroperitoneal solid mass. Treatment is primarily surgical with the main objective resection in healthy margins (R0) obtained by a technically challenging compartmental resection surgery. Instead of radiation therapy and chemotherapy within a multimodal treatment (neo adjuvant or adjuvant) is discussed based on the evolving risks and opportunities excision. The relapse rate is related to tumor grade and surgical margin. The final prognosis is closely related to the quality of initial management and the volume of cases handled by the center.
The RPS has a poor prognosis. The quality of the initial management directly impacts the disease-free survival and overall survival. The multidisciplinary management coordinated within a referent care network of sarcoma pathology is an imperative necessity. © 2016 Elsevier Masson SAS. All rights reserved.
本文旨在依据外生殖器组CCAFU关于腹膜后肉瘤诊断、治疗及监测的建议,供泌尿外科医生参考。
多学科工作小组基于对PubMed上文献的详尽回顾、参考文献评估、证据水平,对2013年指南进行了更新,以确定推荐等级。
从临床怀疑腹膜后肉瘤开始,胸腹部及盆腔计算机断层扫描是金标准。磁共振成像对手术规划有用。在活检确诊前,应常规将病例纳入法国肉瘤病理参考网络。推荐采用经腹膜后途径在扫描仪引导下进行活检,且应在对可疑腹膜后实性肿块进行任何治疗处理之前完成。治疗主要为手术,主要目标是通过具有技术挑战性的分区切除手术获得切缘阴性(R0)的切除。基于不断变化的切除风险和机会,讨论了多模式治疗(新辅助或辅助)中放疗和化疗的应用。复发率与肿瘤分级和手术切缘有关。最终预后与初始治疗质量及中心处理的病例数量密切相关。
腹膜后肉瘤预后较差。初始治疗质量直接影响无病生存期和总生存期。在肉瘤病理参考护理网络内协调多学科管理势在必行。© 2016爱思唯尔马松出版社。保留所有权利。