Modern strategy of treatment of patients with retroperitoneal sarcomas: A review

Abstract

Retroperitoneal sarcomas are rare tumors of non epithelial origin. There are no standards of surgical treatment, chemotherapy or radiation. In 2021 Transatlantic Australasian RPS Working Group published consensus recommendation for diagnosis, treatment and follow-up of retroperitoneal sarcomas patients. The paper presents the main points of the consensus and discusses the surgical aspects of the recommendations, listing the histologic forms excluded from the retroperitoneal tumor group. The main strategy for surgical treatment is emphasized, which includes the necessity to remove retroperitoneal tumors en bloc as well as the necessity to consider the histological structure. Preoperative morphological examination of the tumor, specifying the subtype, should become a standard of examination of patients. The role of multidisciplinary advisory councils as a factor influencing the improvement of survival rate is pointed out. The experience of abdominal department interventions on the great vessels in the context of the experience of large surgical centers is presented. Topical issues of tumor non-resectability, chemotherapy and radiation therapy, perioperative management of patients, including the principles of accelerated recovery after surgery (ERAS) are considered. The results of preoperative irradiation of retroperitoneal sarcoma patients (STRASS1) are presented and the protocol of neoadjuvant therapy (STRASS2) is announced.