Adjacent, Adherent, Invaded: A Spectrum of Biologic Aggressiveness Rather Than a Rationale for Selecting Organ Resection in Surgery of Primary Retroperitoneal Sarcomas

Excerpt

Complete surgical resection of retroperitoneal sarcoma (RPS) remains the only potential curative treatment. The surgical strategy to achieve this optimal and most appropriate resection for each patient still creates some contention and controversy. Most contentious in this debate is the approach to the organs and structures neighboring a retroperitoneal sarcoma, with surgical strategy covering a spectrum from a conservative approach of organ-preserving and simple excision of the tumor alone to resection of the tumor and contiguous organs only when evidence of direct involvement exists to liberal multivisceral compartmental or extended resection of contiguous organs even if uninvolved. In the future, as more information is collected in a standardized and prospective fashion from specialist sarcoma units, this debate should evolve to define the most appropriate and personalized strategy, including extent of surgery, for each patient based on all available patient and prognostic factors. …