TY  - CHAP
M1  - Book, Section
TI  - Retroperitoneal Sarcomas
A1  - Yoon, Sam S.
A2  - Morita, Shane Y.
A2  - Balch, Charles M.
A2  - Klimberg, V. Suzanne
A2  - Pawlik, Timothy M.
A2  - Posner, Mitchell C.
A2  - Tanabe, Kenneth K.
PY  - 2018
T2  - Textbook of Complex General Surgical Oncology
AB  - Approximately  15%  of  soft  tissue  sarcomas  (STS)  occur  in  the  retroperitoneum,  and  thus,  there  are  only  approximately  1600  new  retroperitoneal  sarcomas  (RPS)  in  the  United  States  per  year.1  In  large  series,  the  average  age  is  between  50  and  60  years  old  and  there  are  equal  numbers  of  men  and  women.2-4  RPS  are  frequently  asymptomatic  until  reaching  large  sizes,  and  thus  the  average  size  of  tumors  is  often  greater  than  10  to  15  cm.  The  optimal  local  therapy  for  RPS  includes  surgical  resection  with  negative  microscopic  margins,  but  many  if  not  most  tumors  cannot  be  removed  in  this  fashion.  Even  with  complete  surgical  resection,  local  recurrence  rates  can  approach  50%  or  greater.  An  important  aspect  of  RPS  is  that  even  though  many  of  these  tumors  are  large  and  high  grade,  the  metastasis  rate  is  significantly  lower  than  that  of  extremity  and  truncal  tumors,  with  the  most  common  sites  of  metastasis  being  the  lung  and  liver.5  Thus,  local  recurrence  is  the  leading  cause  of  death  in  RPS  patients.  The  role  of  preoperative  or  postoperative  radiation  therapy  in  reducing  local  recurrence  of  extremity  and  trunk  STS  is  firmly  established  by  prospective,  randomized  trials.6-8  In  contrast  RPS  are  generally  large  and  abut  radiation-sensitive  organs  such  as  the  kidney,  liver,  and  small  bowel,  making  the  delivery  of  adequate  doses  of  preoperative  radiation  difficult.9  The  role  of  adjuvant  chemotherapy  in  reducing  local  recurrence  rates  in  any  location  is  modest  at  best.10  More  recent  studies  of  more  aggressive  surgery  and  advanced  radiation  techniques  have  suggested  that  local  recurrence  can  potentially  be  reduced,  but  these  strategies  are  debatable.  Newer  chemotherapies  and  targeted  agents  may  also  play  a  role  in  the  reduction  of  local  recurrence  rates.  This  chapter  summarizes  the  current  management  of  RPS  with  emphasis  on  surgical  resection  and  radiation  therapy.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - hemonc.mhmedical.com/content.aspx?aid=1145756799
ER  -