Advertisement

Management of Abdominopelvic Sarcoma

  • Paul Sugarbaker

Overview

The principles of management of all sarcomas that involve the abdominal and pelvic cavity are presented. The anatomic sites for the primary malignancy include retroperitoneal sarcomas, pelvic side wall sarcomas, sarcomas arising from the abdominal viscera and sarcomas arising from the pelvic organs. All histologic types of sarcomas may be considered together when therapeutic options are being discussed. This presentation stresses surgical removal with an adequate margin of resection as the principal goal of management. The curative treatment of these cancers places great emphasis on the surgeon’s knowledge of anatomy, technical skills, innovation and surgical courage. Systemic chemotherapy and radiotherapy have not shown reproducible efficacy. Complete clearance at the margins of resection and complete containment of tumor spillage remains the only reliable treatment option. Possible benefits of induction chemotherapy to reduce the size of advanced primary tumors prior to attempts at resection and intraperitoneal chemotherapy using heated cisplatin and doxorubicin for eradication of microscopic residual disease in the perioperative period are presented.

Keywords

Intraperitoneal Chemotherapy Epithelioid Sarcoma Retroperitoneal Sarcoma Abdominal Adhesion Tumor Spillage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sondak VK, Economou JS, Eilber FR. Soft tissue sarcomas of the extremity and retroperitoneum: advances in management. Adv Surg. 1991;24P:333–59.Google Scholar
  2. 2.
    Van Dam PA, Lowe PG, McKenzie-Gray B, Shepherd JH. Retroperitoneal soft tissue sarcomas. Obstet Gynecol Surv. 1990;45:670–82.PubMedGoogle Scholar
  3. 3.
    Lawrence W Jr, Neifeld JP Soft tissue sarcomas. Curr Probl Surg. 1989;26:753–827.CrossRefPubMedGoogle Scholar
  4. 4.
    Storm FK, Sondak VK, Economou JS. Sarcomas of the retroperitoneum. In: Eilber FC et al., editors. Soft Tissue Sarcomas. New York: Grune & Stratton, 1987:239–48.Google Scholar
  5. 5.
    Licht JD, Weissmann LB, Antman K. Gastrointestinal sarcomas. Semin Oncol. 1988;15:181–8.PubMedGoogle Scholar
  6. 6.
    Tsu Y, Lee M. Leiomyosarcoma of the gastrointestinal tract: general pattern of metastases and recurrence. Cancer Treat Rev. 1983;10:91–101.Google Scholar
  7. 7.
    Weiss L. Principles of Metastasis. New York: Academic Press, Harcourt Brace Jovanovich; 1985:187–9.Google Scholar
  8. 8.
    Glenn J, Sindelar WF, Kinsella T et al. Results of multimodality therapy of resectable soft-tissue sarcomas of the retroperitoneum. Surgery. 1985;97:316–25.PubMedGoogle Scholar
  9. 9.
    Potter DA, Glenn J, Kinsella T et al. Patterns of recurrence in patients with high-grade soft-tissue sarcomas. J Clin Oncol. 1985;3:353–66.PubMedGoogle Scholar
  10. 10.
    Sporn MD, Roberts AB. Peptide growth factors and inflammation, tissue repair and cancer. J Clin Invest. 1986; 78:329–32.PubMedGoogle Scholar
  11. 11.
    Sugarbaker TA, Chang D, Koslowe P, Sugarbaker PH. Patterns of spread of recurrent intra-abdominal sarcoma. In: Sugarbaker PH, editor. Peritoneal Carcinomatosis: Principles of Management. Boston: Kluwer; 1996:65–78.Google Scholar
  12. 12.
    Sugarbaker PH. Observations concerning cancer spread within the peritoneal cavity and concepts supporting an ordered pathophysiology. In: Sugarbaker PH, editor. Peritoneal Carcinomatosis: Principles of Management. Boston: Kluwer; 1996:79–100.Google Scholar
  13. 13.
    Enneking WF, Spanier SS, Malawer MM. The effects of the anatomic setting on the results of surgical procedures for soft part sarcoma of the thigh. Cancer. 1981;47:1005–22.PubMedGoogle Scholar
  14. 14.
    Mazeron JJ, Suit HD. Lymph nodes as sites of metastases from sarcomas of soft tissue. Cancer. 1987;60:1800–8.PubMedGoogle Scholar
  15. 15.
    McGrath PC, Neifeld JP Lawrence W et al. Improved survival following complete excision of retroperitoneal sarcomas. Ann Surg. 1984;200:200–4.PubMedGoogle Scholar
  16. 16.
    Berthet B, Sugarbaker TA, Chang D, Sugarbaker PH. Quantitative methodologies for selection of patients with recurrent abdominopelvic sarcoma for treatment. Eur J Cancer. 1999;35:413–19.CrossRefPubMedGoogle Scholar
  17. 17.
    Eroglu A, Kocaoglu H, Demirci S, Akgul H. Retroperitoneal soft tissue sarcoma: effect of hyperthermic total abdominal perfusion. Tumori. 1999;85:259–64.PubMedGoogle Scholar
  18. 18.
    Eilber FC, Rosen G, Forscher C, Nelson SD, Dorey FJ, Eilber FR. Surgical resection and intraperitoneal chemotherapy for recurrent abdominal sarcomas. Ann Surg Oncol. 1999;6:645–50.CrossRefPubMedGoogle Scholar
  19. 19.
    Kinsella TJ, Sindelar WF, Lack E, Glatstein E, Rosenberg SA. Preliminary results of a randomized study of adjuvant radiation therapy in resectable adult retroperitoneal soft tissue sarcomas. J Clin Oncol. 1988;6:18–25.PubMedGoogle Scholar
  20. 20.
    Tepper JE, Suit HD, Wood WC, Proppe KH, Harmon D, McNulty P. Radiation therapy of retroperitoneal soft tissue sarcomas. Int J Radiat Oncol Biol Phys. 1984;10: 825–30.PubMedGoogle Scholar
  21. 21.
    Elias AD, Antman KH. Adjuvant chemotherapy for soft tissue sarcoma: a critical appraisal. Semin Surg Oncol. 1988;4:59–65.PubMedGoogle Scholar
  22. 22.
    Sugarbaker PH. Peritonectomy procedures. Ann Surg. 1995;221:29–42.PubMedGoogle Scholar
  23. 23.
    Karakousis CP, Kontzoglou K, Driscoll DL. Intraperitoneal chemotherapy in disseminated abdominal sarcoma. Ann Surg Oncol. 1997;4:496–8.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Paul Sugarbaker

There are no affiliations available

Personalised recommendations