Sun Steven, Cardona Kenneth, Tseng William W
Division of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, California, USA.
Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, USA.
Cancer Med. 2025 Aug;14(15):e71129. doi: 10.1002/cam4.71129.
Soft tissue sarcomas are a diverse group of rare cancers, with approximately 15%-20% found in the retroperitoneum. Liposarcomas (LPS) make up approximately half of all retroperitoneal (RP) sarcomas, with most cases classified as either well-differentiated (WD) or dedifferentiated (DD). DD LPS is more aggressive, with a higher local recurrence rate and risk of distant metastasis compared to WD LPS. The purpose of this review is to outline surgical management of RP LPS and highlight the multimodal treatment strategies for both primary and recurrent disease, along with considerations for their effective implementation.
The current medical literature was reviewed for studies focused on retroperitoneal liposarcoma and its treatment with surgery, radiation, and chemotherapy. The data was interpreted and compiled in the context of expert clinical experience.
Along with histopathologic analysis, tumor biology can inform patient prognosis. Surgery, the standard treatment for RP LPS, can be either curative or palliative. In primary disease, an attempt should be made to achieve wide surgical margins when feasible. Surgery for recurrent disease requires careful timing and an understanding of the potential benefit versus risk. Neoadjuvant radiation therapy can improve local control of RP LPS; however, data supporting the use of neoadjuvant chemotherapy are currently lacking.
Multimodality treatment of RP LPS is complex and requires consideration of tumor biology and extent of disease, along with individual patient characteristics. Multidisciplinary team collaboration is critical for improving outcomes in patients with RP LPS.
软组织肉瘤是一组多样的罕见癌症，约15%-20%发生于腹膜后。脂肪肉瘤（LPS）约占所有腹膜后（RP）肉瘤的一半，大多数病例分为高分化（WD）或去分化（DD）型。与WD LPS相比，DD LPS侵袭性更强，局部复发率和远处转移风险更高。本综述的目的是概述RP LPS的手术治疗，并强调原发性和复发性疾病的多模式治疗策略，以及有效实施这些策略的注意事项。
回顾当前医学文献，查找聚焦于腹膜后脂肪肉瘤及其手术、放疗和化疗治疗的研究。结合专家临床经验对数据进行解读和汇总。
除组织病理学分析外，肿瘤生物学特性也可提示患者预后。手术是RP LPS的标准治疗方法，可为根治性或姑息性。对于原发性疾病，可行时应尝试实现广泛的手术切缘。复发性疾病的手术需要谨慎选择时机，并了解潜在的获益与风险。新辅助放疗可改善RP LPS的局部控制；然而，目前缺乏支持使用新辅助化疗的数据。
RP LPS的多模式治疗很复杂，需要考虑肿瘤生物学特性、疾病范围以及个体患者特征。多学科团队协作对于改善RP LPS患者的治疗结局至关重要。
