The role and outcomes of palliative surgery for retroperitoneal sarcoma

The role and outcomes of palliative surgery for retroperitoneal sarcoma INTRODUCTIONIn a sense, the majority of surgical procedures performed in patients with retroperitoneal sarcoma (RPS) could be regarded as “palliative.” Large surgical series with long‐term follow‐up have shown that while the recurrence rate is highest within the first two years following complete resection of primary RPS, recurrences continue to occur 15‐20 years later, with no apparent plateau. The very long‐term recurrence‐free survival rate is less than 25% in such series. For recurrent RPS, whether local or distant, the disease‐specific survival rates following resection are worse still. However, recent improvements in the quality of surgical resection may translate to improved long‐term outcomes. In keeping with the latter expectation, a consensus statement by the Trans‐Atlantic RPS working group (TARPSWG) emphasizes that the best chance of curative resection is at time of primary presentation, with discussion of every patient at a multidisciplinary sarcoma conference where adjuvant therapies can be considered as the optimal approach to “curative‐intent” management is developed for the individual patient. By contrast, the role of surgery in patients who are not eligible for a curative approach is fraught with uncertainty and controversy.The term “palliative care” was first coined in 1975 by Balfour Mount, a Canadian urologist who started a http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Surgical Oncology Wiley

The role and outcomes of palliative surgery for retroperitoneal sarcoma

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
0022-4790
eISSN
1096-9098
D.O.I.
10.1002/jso.24934
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONIn a sense, the majority of surgical procedures performed in patients with retroperitoneal sarcoma (RPS) could be regarded as “palliative.” Large surgical series with long‐term follow‐up have shown that while the recurrence rate is highest within the first two years following complete resection of primary RPS, recurrences continue to occur 15‐20 years later, with no apparent plateau. The very long‐term recurrence‐free survival rate is less than 25% in such series. For recurrent RPS, whether local or distant, the disease‐specific survival rates following resection are worse still. However, recent improvements in the quality of surgical resection may translate to improved long‐term outcomes. In keeping with the latter expectation, a consensus statement by the Trans‐Atlantic RPS working group (TARPSWG) emphasizes that the best chance of curative resection is at time of primary presentation, with discussion of every patient at a multidisciplinary sarcoma conference where adjuvant therapies can be considered as the optimal approach to “curative‐intent” management is developed for the individual patient. By contrast, the role of surgery in patients who are not eligible for a curative approach is fraught with uncertainty and controversy.The term “palliative care” was first coined in 1975 by Balfour Mount, a Canadian urologist who started a

Journal

Journal of Surgical OncologyWiley

Published: Jan 1, 2018

Keywords: ; ; ;

References

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