Asencio Pascual José Manuel, Fernandez Hernandez Juan Angel, Blanco Fernandez Gerardo, Muñoz Casares Cristobal, Álvarez Álvarez Rosa, Fox Anzorena Bárbara, Lozano Borbalas Alicia, Rodriguez Blanco Manuel, Cantin Blázquez Sonia, Artigas Raventós Vicente
Grupo Tumores Mesenquimales/Sarcomas, AEC, Madrid, España.
Oncologia Médica, Hospital Universitario Gregorio Marañón, Madrid, España.
Cir Esp (Engl Ed). 2019 Nov;97(9):480-488. doi: 10.1016/j.ciresp.2019.06.011. Epub 2019 Sep 12.
Surgery for retroperitoneal sarcomas should be "en bloc" compartmental, which involves resection of unaffected organs. Its upfront use is key, providing a high percentage of resections with negative margins, resulting in a better local control and increased survival in many patients. Preservation of organs should be done in an individualized manner, especially in the pelvic location, and adapted to the histological aggressiveness of the tumor. Preoperative biopsy is able to establish the diagnosis of sarcoma subtype and consequently an adequate perioperative strategy. These patients should be managed by expert surgeons at referral centers with multidisciplinary units and oncology committees. The use of chemotherapy and radiotherapy is not yet well defined, so it is only recommended at referral centers with clinical trials. Currently, this is the only option to offer the best morbidity and mortality rates, as well as possible improvements in the survival of these patients.
腹膜后肉瘤的手术应采用“整块”分区切除，这涉及切除未受影响的器官。其早期应用是关键，可实现高比例的切缘阴性切除，从而在许多患者中实现更好的局部控制并提高生存率。器官保留应以个体化方式进行，尤其是在盆腔部位，并应根据肿瘤的组织学侵袭性进行调整。术前活检能够确立肉瘤亚型的诊断，从而制定适当的围手术期策略。这些患者应由具有多学科团队和肿瘤学委员会的转诊中心的专家外科医生进行管理。化疗和放疗的应用尚未明确界定，因此仅在有临床试验的转诊中心推荐使用。目前，这是提供最佳发病率和死亡率以及可能改善这些患者生存率的唯一选择。
