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[腹膜后软组织肉瘤:外科治疗]

[Retroperitoneal soft tissue sarcoma: surgical management].

作者信息

Willis Franziska, Schneider Martin

机构信息

Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland.

出版信息

Chirurg. 2022 Jan;93(1):16-26. doi: 10.1007/s00104-021-01506-6. Epub 2021 Oct 1.

Abstract

BACKGROUND

Retroperitoneal soft tissue sarcomas are rare and heterogeneous tumors with high recurrence rates that require a multimodal treatment approach and a surgical resection strategy adapted to tumor localization and histological subtype.

OBJECTIVE

Based on current scientific data this article intends to provide an overview on subtype-specific features, prognostic factors and operative techniques in the surgical management of retroperitoneal soft tissue sarcomas.

MATERIAL AND METHODS

A review of the literature addressing surgical management of retroperitoneal soft tissue sarcomas was performed. Current evidence and recommendations were summarized.

RESULTS AND CONCLUSION

Macroscopically complete tumor resection represents the sole curative treatment option for both primary and recurrent retroperitoneal soft tissue sarcomas. To minimize the probability of tumor-infiltrated resection margins, compartmental resection has become a standard treatment for retroperitoneal soft tissue sarcomas. This approach includes resection of all organs and structures adjacent to the tumor. Multivisceral resection is often associated with this approach and it is acceptable in terms of morbidity and mortality if performed at a center with experience in retroperitoneal sarcoma surgery. Histologic subtype, tumor grading, and quality of initial surgical treatment are major prognostic factors for oncologic overall survival.

摘要

背景

腹膜后软组织肉瘤是罕见的异质性肿瘤,复发率高,需要多模式治疗方法以及根据肿瘤定位和组织学亚型调整的手术切除策略。

目的

基于当前科学数据,本文旨在概述腹膜后软组织肉瘤外科治疗中的亚型特异性特征、预后因素和手术技术。

材料与方法

对有关腹膜后软组织肉瘤外科治疗的文献进行综述。总结当前证据和建议。

结果与结论

肉眼下肿瘤完整切除是原发性和复发性腹膜后软组织肉瘤唯一的治愈性治疗选择。为了将肿瘤浸润切缘的可能性降至最低,分区切除已成为腹膜后软组织肉瘤的标准治疗方法。该方法包括切除与肿瘤相邻的所有器官和结构。多脏器切除常与该方法相关联,如果在有腹膜后肉瘤手术经验的中心进行,其发病率和死亡率是可以接受的。组织学亚型、肿瘤分级和初始手术治疗质量是肿瘤总体生存的主要预后因素。

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