Surgical resection is the cornerstone of curative treatment for retroperitoneal sarcomas (RPS), aiming for complete excision, yet the complexity of RPS with its proximity to vital structures continues to lead to high local recurrence rates after surgery alone. Thus, the role of radiotherapy (RT) continues to be refined to improve local control, which remains an important goal to prevent RPS recurrence. The recently completed global randomized trial to evaluate the role of surgery with and without preoperative RT – STRASS1, did not demonstrate a significant overall benefit for neoadjuvant RT based on the pre-specified definition of abdominal recurrence-free survival, however, sensitivity analysis using a standard definition of local recurrence and analysis of outcomes by compliance to the RT protocol suggests histology-specific benefit in well- and some de-differentiated liposarcomas. Ultimately, multidisciplinary collaboration and personalized approaches that consider histological sarcoma types and patient-specific factors are imperative for optimizing the therapeutic strategy in the management of RPS.

中文翻译：

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腹膜后肉瘤治疗进展：手术和放射治疗方法

手术切除是腹膜后肉瘤 (RPS) 根治性治疗的基石，旨在完全切除，但 RPS 的复杂性及其靠近重要结构仍然导致单纯手术后局部复发率较高。因此，放射治疗 (RT) 的作用不断完善，以改善局部控制，这仍然是预防 RPS 复发的重要目标。最近完成的全球随机试验评估了术前放疗和不放疗的手术作用 - STRASS1，根据预先指定的腹部无复发生存率定义，并未证明新辅助放疗具有显着的总体益处，然而，使用局部复发的标准定义和通过遵守 RT 方案进行的结果分析表明，在良好和一些去分化脂肪肉瘤中具有组织学特异性益处。最终，考虑组织学肉瘤类型和患者特异性因素的多学科协作和个性化方法对于优化 RPS 管理的治疗策略至关重要。