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Porrello G, Cannella R, Randazzo A, Badalamenti G, Brancatelli G, Vernuccio F. CT and MR Imaging of Retroperitoneal Sarcomas: A Practical Guide for the Radiologist. Cancers (Basel) 2023; 15:cancers15112985. [PMID: 37296946 DOI: 10.3390/cancers15112985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Primary retroperitoneal sarcomas (RPS) represent around 10-16% of all sarcomas, with liposarcomas and leiomyosarcomas being the most common subtypes. RPS have some peculiar characteristics, imaging appearances, worse prognosis, and complications compared to other locations of sarcoma. Commonly, RPS primarily present as large masses, progressively encasing adjacent structures, causing mass effect, and complications. RPS diagnosis is often challenging, and these tumors may be overlooked; however, failure to recognize RPS characteristics leads to a worse prognosis for the patients. Surgery is the only recognized curative treatment, but the anatomical constraints of the retroperitoneum limit the ability to achieve wide resection margins; therefore, these tumors have a high rate of recurrence, and require long-term follow-up. The radiologist has an important role in the diagnosis of RPS, the definition of their extent, and their follow-up. Specific knowledge of the main imaging findings is required to reach an early diagnosis, and, ultimately, to guarantee the best patient management. This article provides an overview of the current knowledge regarding cross-sectional imaging features of patients with retroperitoneal sarcomas, presenting tips and tricks to improve imaging diagnosis of RPS.
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Affiliation(s)
- Giorgia Porrello
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnosis (Bi.N.D), University of Palermo, 90127 Palermo, Italy
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Via Tricomi 5, 90127 Palermo, Italy
| | - Roberto Cannella
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnosis (Bi.N.D), University of Palermo, 90127 Palermo, Italy
| | - Angelo Randazzo
- Department of Radiology, Azienda Sanitaria Provinciale, 92100 Agrigento, Italy
| | - Giuseppe Badalamenti
- Section of Medical Oncology, Department of Surgical, Oncological and Oral Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy
| | - Giuseppe Brancatelli
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnosis (Bi.N.D), University of Palermo, 90127 Palermo, Italy
| | - Federica Vernuccio
- Department of Radiology, University Hospital of Padova, 35128 Padova, Italy
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Lei T, Guo X, Gong C, Chen X, Ran F, He Y, Shi Q, He J. High-intensity focused ultrasound ablation in the treatment of recurrent ovary cancer and metastatic pelvic tumors: a feasibility study. Int J Hyperthermia 2021; 38:282-287. [PMID: 33612045 DOI: 10.1080/02656736.2021.1889698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To explore the feasibility of high-intensity focused ultrasound (HIFU) ablation for treating metastatic pelvic tumors and recurrent ovary cancer. MATERIALS AND METHODS Eight patients with metastatic pelvic tumors or recurrent ovary cancer were enrolled in this study. Among them, 5 patients had ovarian cancer, 1 had cervical cancer, 1 had endometrial cancer, and 1 had rectal cancer. Six of them received abdominal surgical operation for their primary cancer, no one received radiotherapy. HIFU treatment was performed under conscious sedation. Vital signs were monitored during the procedure, and adverse effects were recorded. Postoperative follow-up was performed to observe pain relief and the improvement of the patient's quality of life. RESULTS The median age of the patients was 54 (range: 33-76) years, with a total of 12 lesions. The average volume of the lesions was 238.0 cm3. Six patients completed 12 months follow-up. Postoperative pain relief rate was 60% (3/5), and the quality of life improved in the short term. The main adverse effect of HIFU was pain in the treated area, with the pain score lower than 4, and all of which was self-relieved within 1 day after HIFU treatment. No serious complications such as skin burn, intestinal perforation, and nerve injury occurred. CONCLUSION HIFU is feasible for the treatment of metastatic pelvic tumors or recurrent ovary cancer without serious complications. Therefore, HIFU seems a promising treatment for recurrent ovary cancer, metastatic pelvic tumors from cervical cancer, endometrial cancer, and rectal cancer.
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Affiliation(s)
- Tingting Lei
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Department of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Sichuan, PR China
| | - Xu Guo
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Department of Oncology, Suining Municipal Hospital of Traditional Chinese Medicine, Sichuan, PR China
| | - Chunmei Gong
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Xuelian Chen
- Department of Oncology, Suining Municipal Hospital of Traditional Chinese Medicine, Sichuan, PR China
| | - Feng Ran
- Department of Oncology, Suining Municipal Hospital of Traditional Chinese Medicine, Sichuan, PR China
| | - Yuchun He
- Department of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Sichuan, PR China
| | - Qiuling Shi
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Jia He
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Department of Gynecology and Obstetrics, Suining Municipal Hospital of Traditional Chinese Medicine, Sichuan, PR China
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Hwang H, Kwon YH, Lim HK, Kim J, Park KJ. Retroperitoneal sarcomas: Outcomes of repeated resections. KOREAN JOURNAL OF CLINICAL ONCOLOGY 2020; 16:96-103. [PMID: 36945717 PMCID: PMC9942735 DOI: 10.14216/kjco.20015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 08/18/2020] [Accepted: 11/18/2020] [Indexed: 11/07/2022]
Abstract
Purpose Retroperitoneal sarcomas (RPS) are rare malignant tumors arising from mesenchymal cells. The objective of this study was to review the treatment experiences and to identify prognostic factors for overall survival (OS) after primary resection and subsequent reoperations for recurrences. Methods The medical records of patients who underwent resection for RPS at our institution between June 2002 and December 2016 were retrospectively reviewed. Univariate and multivariable Cox proportional hazards modeling was used to assess the prognostic factors for OS. Results A total of 48 patients were enrolled. On multivariable analysis in primary resection group, the FNCLCC (Fédération Nationale des Centres de Lutte Contre le Cancer) grade was a significant prognostic factor for OS (P=0.006). The patients who received chemotherapy after primary resection were significantly associated with poor prognosis (P=0.009). The 5-year OS rate after primary resection (n=48) were 58.1% and the 5-year cumulative reoperation rate after primary resection was 62.5%. After second resection for recurrence after primary resection (n=23), the 5-year OS rate was 64.3%. There was a tendency towards decreased surgery-free survival rate as the number of repeated resections for recurrent RPS increased. In the subset of patients (n=16) who underwent more than 3 repeated resections at our institute, the 5-year OS rate was 75.0%, indicating that repeated resections are not associated with worse outcome. Conclusion Only low tumor grade was an independent favorable prognostic factor for OS. Although the prognosis for RPS remains poor, repeated resections for recurrence are not associated with poor prognosis. Aggressive surgical strategies for recurred RPS patients are warranted.
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Affiliation(s)
- Hyeonuk Hwang
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon-Hye Kwon
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Ki Lim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jeesun Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Joo Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Makris MC, Athanasopoulos PG, Kornaropoulos M, Chrysocheris P, Antonakopoulos F, Mathioulaki A, Tsilimigras DI, Ioannidis A, Konstantinidis MK, Moris D, Konstantinidis KM. Robotic resection of a giant retroperitoneal leiomyosarcoma: A case report. Mol Clin Oncol 2019; 11:599-601. [PMID: 31693012 DOI: 10.3892/mco.2019.1928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 04/11/2019] [Indexed: 11/06/2022] Open
Abstract
The management of abdominal leiomyosarcoma is challenging. Surgical excision is considered the only effective treatment; however, this is associated with considerable morbidity. Robotic surgery has emerged during the past decades and has enhanced the general surgery armamentarium, allowing surgeons to carry out demanding operations in a safe manner. The surgical resection of retroperitoneal leiomyosarcoma (RPLM) can be associated with significant morbidity, which is primarily due to the origin or the close proximity of the tumor with important vascular structures, including the inferior vena cava and tributaries, the duodenum and the ureter. The present case describes the first case of robotic resection of RPLM in a high-volume robotic center. In the present case, a large RPLM was safely removed with respect to oncological principles with the use of the Da Vinci platform.
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Affiliation(s)
- Marinos C Makris
- First Surgical Department, General Hospital of Athens 'G. Gennimatas', Athens 11527, Greece.,Alpha Institute of Biomedical Sciences (AIBS), Athens 15123, Greece
| | - Panos G Athanasopoulos
- Department of General, Laparoscopic, Robotic and Bariatric Surgery, Athens Medical Center, Athens 15125, Greece
| | - Michael Kornaropoulos
- First Surgical Department, General Hospital of Athens 'G. Gennimatas', Athens 11527, Greece
| | - Periclis Chrysocheris
- Department of General, Laparoscopic, Robotic and Bariatric Surgery, Athens Medical Center, Athens 15125, Greece
| | - Fotios Antonakopoulos
- Department of General, Laparoscopic, Robotic and Bariatric Surgery, Athens Medical Center, Athens 15125, Greece
| | - Antonia Mathioulaki
- Department of General, Laparoscopic, Robotic and Bariatric Surgery, Athens Medical Center, Athens 15125, Greece
| | | | - Argyrios Ioannidis
- Second Surgical Department, Sismanoglion General Hospital, Athens 15126, Greece
| | | | - Demetrios Moris
- School of Medicine, National and Kapodistrian University of Athens, Athens 11527, Greece
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Moris D, Petrou A, Papalampros A, Tsilimigras DI, Felekouras E. Retroperitoneal sarcomas: does the center really matter? Surgery 2017; 163:971-972. [PMID: 29203285 DOI: 10.1016/j.surg.2017.10.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 10/11/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Dimitrios Moris
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Athanasios Petrou
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Papalampros
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Diamantis I Tsilimigras
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Felekouras
- First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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