Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2012

01-09-2012 | Bone and Soft Tissue Sarcomas

Technical Considerations in Surgery for Retroperitoneal Sarcomas: Position Paper from E-Surge, a Master Class in Sarcoma Surgery, and EORTC–STBSG

Authors: Syvie Bonvalot, MD, PhD, Chandrajit P. Raut, MD, MSc, Raphael E. Pollock, MD, PhD, Piotr Rutkowski, MD, Dirk C. Strauss, MD, Andrew J. Hayes, MD, Frits Van Coevorden, MD, Marco Fiore, MD, Eberhard Stoeckle, MD, Peter Hohenberger, MD, PhD, Alessandro Gronchi, MD

Published in: Annals of Surgical Oncology | Issue 9/2012

Login to get access

Abstract

Background

Surgery is the principal treatment for retroperitoneal sarcoma. These tumors typically involve or abut multiple organs and therefore require multivisceral resections. Despite the complexity of such operations, a standardized approach has not been described. As a result, referral centers often see patients who have undergone suboptimal surgery, with gross disease left behind. This is one of the causes of the dismal prognosis of this disease.

Methods

These consensus statements came out from E-Surge, an educational symposium with live sarcoma surgery, performed by European and North American expert sarcoma surgeons illustrating an optimal technique to an international audience, held in 2010 and 2011. The content was then shared among members of the local subcommittee of European Organization for Research and Treatment of Cancer (EORTC)–Soft Tissue and Bone Sarcoma Group (STBSG).

Results

An attempt to describe a reproducible and standardized approach to these tumors is illustrated. A detailed description of the different procedures according to the variety of different presentations is made.

Conclusions

The approach described herein should be used as the reference standard in clinical practice and serve to perform quality check of local treatment in future trials.
Literature
1.
Lewis JJ, Leung D, Woodruff JM. Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution. Ann Surg. 1998;228:355–65.PubMedCrossRef
2.
Stoeckle E, Coindre JM, Bonvalot S, et al. Prognostic factors in retroperitoneal sarcoma: a multivariate analysis of a series of 165 patients of the French Cancer Center Federation Sarcoma Group. Cancer. 2001;92:359–68.PubMedCrossRef
3.
Ferrario T, Karakousis CP. Retroperitoneal sarcomas: grade and survival. Arch Surg. 2003;138:248–51.PubMedCrossRef
4.
Kilkenny JW, Bland KI, Copel EM. Retroperitoneal sarcoma: the University of Florida experience. J Am Coll Surg. 1996;182:329–39.PubMed
5.
Gronchi A, Casali PG, Fiore M, et al. Retroperitoneal soft tissue sarcomas: patterns of recurrence in 167 patients treated at a single institution. Cancer. 2004;100:2448–55.PubMedCrossRef
6.
Hassan I, Park SZ, Donohue JH, et al. Operative management of primary retroperitoneal sarcomas: a reappraisal of an institutional experience. Ann Surg. 2004;239:244–50.PubMedCrossRef
7.
van Dalen T, Plooij JM, van Coevorden F, et al. Long-term prognosis of primary retroperitoneal soft tissue sarcoma. Eur J Surg Oncol. 2007;33:234–8.PubMedCrossRef
8.
Lehnert T, Cardona S, Hinz U, et al. Primary and locally recurrent retroperitoneal soft-tissue sarcoma: local control and survival. Eur J Surg Oncol. 2009;35:986–93.PubMedCrossRef
9.
Strauss DC, Hayes AJ, Thway K, et al. Surgical management of primary retroperitoneal sarcoma. Br J Surg. 2010;101:520–3.
10.
Bonvalot S, Rivoire M, Castaing M, et al. Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol. 2009;27:31–7.PubMedCrossRef
11.
Gronchi A, Lo Vullo S, Fiore M, et al. Aggressive surgical policies in a retrospectively reviewed single-institution case series of retroperitoneal soft tissue sarcoma patients. J Clin Oncol. 2009;27:24–30.PubMedCrossRef
12.
Schwarzbach MH, Hohenberger P. Current concepts in the management of retroperitoneal soft tissue sarcoma. Recent Results Cancer Res. 2009;179:301–19.PubMedCrossRef
13.
Gronchi A, Miceli R, Colombo C, et al. Frontline extended surgery is associated with improved survival in retroperitoneal low- to intermediate-grade soft tissue sarcomas. Ann Oncol. 2012;23(4):1067–73.PubMedCrossRef
14.
Bonvalot S, Miceli R, Berselli M. Aggressive surgery in retroperitoneal soft tissue sarcoma carried out at high-volume centers is safe and is associated with improved local control. Ann Surg Oncol. 2010;17:1507–14.PubMedCrossRef
15.
Tseng WH, Martinez SR, Tamurian RM, et al. Contiguous organ resection is safe in patients with retroperitoneal sarcoma: an ACS-NSQIP analysis. J Surg Oncol. 2011;103:390–4.PubMedCrossRef
16.
Irani JL, Ashley SW, Brooks DC, et al. Distal pancreatectomy is not associated with increased perioperative morbidity when performed as part of a multivisceral resection. J Gastroint Surg. 2008;12:2177–82.CrossRef
17.
Berselli M, Coppola S, Colombo C, et al. Morbidity of left pancreatectomy when associated with multivisceral resection for abdominal mesenchymal neoplasms. JOP. 2011;12:138–44.PubMed
18.
Kawaguchi N, Ahmed AR, Matsumoto S, et al. The concept of curative margin in surgery for bone and soft tissue sarcoma. Clin Orthop. 2004;419:165–72.PubMedCrossRef
19.
Lin PP, Pino ED, Normand AN, et al. Periosteal margin in soft tissue sarcoma. Cancer. 2007;109:598–602.PubMedCrossRef
20.
Clarkson PW, Griffin MA, Catton CM, et al. Epineural dissection is a safe technique which facilitates limb salvage surgery. Clin Orthop Rel Res. 2005;438:92–6.
21.
Gronchi A, Lo Vullo S, Colombo C, et al. Extremity soft tissue sarcoma in a series of patients treated at a single institution: local control directly impacts survival. Ann Surg. 2011;251:512–7.
22.
Gerrand CH, Wunder JS, Kandel RA, et al. Classification of positive margins after resection of soft tissue sarcoma of the limb predicts the risk of local recurrence. J Bone Joint Surg Br. 2001;83:1149–55.PubMedCrossRef
23.
Gronchi A, Pollock R. Surgery in retroperitoneal soft tissue sarcoma: a call for a consensus between Europe and North America. Ann Surg Oncol. 2011;18:2107–10.PubMedCrossRef
24.
Lahat G, Madewell JE, Anaya DA, et al. Computed tomography scan-driven selection of treatment for retroperitoneal liposarcoma histologic subtypes. Cancer. 2009;115:1081–90.PubMedCrossRef
25.
Fiore M, Colombo C, Locati P, et al. Surgical technique, morbidity, and outcome of primary retroperitoneal sarcoma involving inferior vena cava. Ann Surg Oncol. 2012;19:511–8.PubMedCrossRef
26.
Schwarzbach MH, Hormann Y, Hinz U, et al. Clinical results of surgery for retroperitoneal sarcoma with major blood vessel involvement. J Vasc Surg. 2006;44:46–55.PubMedCrossRef
27.
Van Vreeland TC, Van Coevorden F, Zoetmulder FAN. Continuous abdominolumbar incision for exposure of the retroperitoneum. J Am Coll Surg. 1995;180:619–20.PubMed
Metadata
Title
Technical Considerations in Surgery for Retroperitoneal Sarcomas: Position Paper from E-Surge, a Master Class in Sarcoma Surgery, and EORTC–STBSG
Authors
Syvie Bonvalot, MD, PhD
Chandrajit P. Raut, MD, MSc
Raphael E. Pollock, MD, PhD
Piotr Rutkowski, MD
Dirk C. Strauss, MD
Andrew J. Hayes, MD
Frits Van Coevorden, MD
Marco Fiore, MD
Eberhard Stoeckle, MD
Peter Hohenberger, MD, PhD
Alessandro Gronchi, MD
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 9/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2342-2

Other articles of this Issue 9/2012

Annals of Surgical Oncology 9/2012 Go to the issue

Colorectal Cancer

Changing Paradigms for Liver Resection of Colorectal Metastases

Hepatobiliary Tumors

Coexpression of Stemness Factors Oct4 and Nanog Predict Liver Resection

Translational Research and Biomarkers

Prognostic Significance of Telomerase Activity and Human Telomerase Reverse Transcriptase Expression in Ampullary Carcinoma

Gastrointestinal Oncology

Pilot Feasibility Study of Neoadjuvant Chemoradiotherapy with S-1 in Patients with Locally Advanced Gastric Cancer Featuring Adjacent Tissue Invasion or JGCA Bulky N2 Lymph Node Metastases

Breast Oncology

The Impact of Obesity on Breast Cancer: A Retrospective Review

Breast Oncology

Evaluation of Tumor Stiffness by Elastography Is Predictive for Pathologic Complete Response to Neoadjuvant Chemotherapy in Patients with Breast Cancer