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Álvarez Álvarez R, Manzano A, Agra Pujol C, Artigas Raventós V, Correa R, Cruz Jurado J, Fernandez JA, Garcia Del Muro X, Gonzalez JA, Hindi N, Lozano Lominchar P, Martínez-Trufero J, Méndez R, Muñoz M, Muñoz Casares C, Orbis Castellanos F, Orellana Fernandez R, Paniagua González M, Redondo A, Valverde Morales C, Asencio JM. Updated Review and Clinical Recommendations for the Diagnosis and Treatment of Patients with Retroperitoneal Sarcoma by the Spanish Sarcoma Research Group (GEIS). Cancers (Basel) 2023; 15:3194. [PMID: 37370803 DOI: 10.3390/cancers15123194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Soft tissue sarcomas (STS) are an uncommon and biologically heterogeneous group of tumors arising from mesenchymal cells. The incidence is estimated at five cases per 100,000 people per year. Retroperitoneal sarcomas (RPS) account for 10-15% of all STS, and their management depends on their anatomical characteristics and histotype. Due to their very low incidence, it is recommended that RPS be treated in reference centers and evaluated by an experienced multidisciplinary team (MDT). In Spain, the Spanish Group for Research in Sarcomas (GEIS) brings together experts from various specialties to promote research on sarcomas and improve treatment results. This paper summarizes the GEIS recommendations for the diagnosis, treatment, and follow-up of patients with RPS.
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Affiliation(s)
- Rosa Álvarez Álvarez
- Medical Oncology Department, Instituto de Investigacion Sanitaria Gregorio Marañon, Hospital Universitario Gregorio Marañon, 28007 Madrid, Spain
| | - Aránzazu Manzano
- Medical Oncology Department, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain
| | - Carolina Agra Pujol
- Pathology Department, Hospital Universitario Gregorio Marañon, Complutense University, 28007 Madrid, Spain
| | - Vicente Artigas Raventós
- Surgery Department, Hospital Universitario Sant Pau, Universidad Autonoma de Barcelona, 08035 Barcelona, Spain
| | - Raquel Correa
- Radiation Oncology Department, Hospital Virgen de la Victoria, 29010 Malaga, Spain
| | - Josefina Cruz Jurado
- Medical Oncology Department, Hospital Universitario Canarias, 38320 Santa Cruz de Tenerife, Spain
| | - Juan Angel Fernandez
- Sarcoma Multidisciplinary Unit, Surgery Department, Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
| | - Xavier Garcia Del Muro
- Sarcoma Multidisciplinary Unit, Medical Oncology Department, Idibell, Instituto Catalan Oncología Hospitalet, 08908 Barcelona, Spain
| | - Jose Antonio Gonzalez
- Surgery Department, Hospital Universitario Sant Pau, Universidad Autonoma de Barcelona, 08035 Barcelona, Spain
| | - Nadia Hindi
- Medical Oncology Department, Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain
- Medical Oncology Department, Hospital General de Villalba, 28400 Madrid, Spain
- Health Research Institute-Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid (UAM), 28040 Madrid, Spain
| | - Pablo Lozano Lominchar
- Surgery Department, Hospital Universitario Gregorio Marañon, Complutense University, 28040 Madrid, Spain
| | | | - Ramiro Méndez
- Radiology Department, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain
| | - Mercedes Muñoz
- Radiation Oncology Department, Hospital Universitario Gregorio Marañon, Complutense University, 28007 Madrid, Spain
| | | | - Francisco Orbis Castellanos
- Sarcoma Multidisciplinary Unit, Surgery Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
| | | | - Miguel Paniagua González
- Radiology Department, Hospital Universitario Gregorio Marañon, Complutense University, 28007 Madrid, Spain
| | - Andres Redondo
- Medical Oncology Department, Hospital Universitario La Paz-IdiPAZ, 28046 Madrid, Spain
| | | | - Jose Manuel Asencio
- Surgery Department, Hospital Universitario Gregorio Marañon, Complutense University, 28040 Madrid, Spain
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Bademci R, Temidayo Talabi MO, Salas P, Blanco MR, Riart GC, Bollo J, Raventós VA. Impact of biliary drainage prior to pancreatectomy. Acta Chir Belg 2022; 122:390-395. [PMID: 33929304 DOI: 10.1080/00015458.2021.1920659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 04/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is still a lack of clarity about the benefits of preoperative biliary drainage (PBD), which was introduced to improve the perioperative outcome in patients with obstructive jaundice caused by a periampullary tumour. The aim of this study was to determine whether operative and postoperative complications increase in patients undergoing PBD during pancreatoduodenectomy (PD). MATERIAL AND METHODS Retrospective examination was made of patients who underwent PBD for a periampullary tumour in our hospital between 2006 and 2014. From these, the patients were identified who had PBD with endoscopic retrograde cholangiopancreatography and these patients were further separated into two groups, as one group of patients with plastic stents and the other group of patients with metallic stents. Patients with pancreas head cancer were also separated into two groups as those who were and were not applied with PBD. The preoperative, intraoperative and postoperative characteristics of the patients were evaluated. RESULTS A total of 123 patients were retrospectively reviewed. Biliary stent placement with PBD was applied to 48 patients, of whom 31 had metallic stents and 17 had plastic stents. In general, there was no difference between the PBD and the non-PBD groups in respect of the preoperative, operative and postoperative results. When patients with tumour of the pancreas head only were examined, the rate of wound infection was higher in the PBD group and there was no difference in the other parameters. Moreover, there was no difference between the patients with metallic stents and those with plastic stents in respect of outcomes. CONCLUSIONS With the exception of wound site infection, although no difference was observed between the PBD and the non-PBD groups based on intraoperative and postoperative complications, because of the distinctive inherent complications of PBD it is essential to manage such patients properly and to carefully select the patients for the PBD procedure.
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Affiliation(s)
- Refik Bademci
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Hospital de la Santa Creu i Sant Pau, University Autònoma de Barcelona, Bellaterra, Spain
| | - Michael Olusegun Temidayo Talabi
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Hospital de la Santa Creu i Sant Pau, University Autònoma de Barcelona, Bellaterra, Spain
| | - Pedro Salas
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Hospital de la Santa Creu i Sant Pau, University Autònoma de Barcelona, Bellaterra, Spain
| | - Manuel Rodríguez Blanco
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Hospital de la Santa Creu i Sant Pau, University Autònoma de Barcelona, Bellaterra, Spain
| | - Gemma Cerdán Riart
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Hospital de la Santa Creu i Sant Pau, University Autònoma de Barcelona, Bellaterra, Spain
| | - Jesus Bollo
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Hospital de la Santa Creu i Sant Pau, University Autònoma de Barcelona, Bellaterra, Spain
| | - Vicente Artigas Raventós
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Hospital de la Santa Creu i Sant Pau, University Autònoma de Barcelona, Bellaterra, Spain
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Artigas Raventós V. How much to improve in the surgery of mesenchymal and sarcoma tumors. Cir Esp 2022; 100:191-192. [PMID: 35431158 DOI: 10.1016/j.cireng.2021.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/11/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Vicente Artigas Raventós
- Coordinador Sección Tumores Mesenquimales y Sarcomas, Asociación Española de Cirugía, Madrid, Spain.
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Artigas Raventós V. How much to improve in the surgery of mesenchymal and sarcoma tumors. Cir Esp 2021; 100:S0009-739X(21)00214-1. [PMID: 34274103 DOI: 10.1016/j.ciresp.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Vicente Artigas Raventós
- Coordinador Sección Tumores Mesenquimales y Sarcomas, Asociación Española de Cirugía, Madrid, España.
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Asencio Pascual JM, Fernandez Hernandez JA, Blanco Fernandez G, Muñoz Casares C, Álvarez Álvarez R, Fox Anzorena B, Lozano Borbalas A, Rodriguez Blanco M, Cantin Blázquez S, Artigas Raventós V. Update in pelvic and retroperitoneal sarcoma management: The role of compartment surgery. Cir Esp 2019; 97:480-488. [PMID: 31521244 DOI: 10.1016/j.ciresp.2019.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/22/2019] [Accepted: 06/21/2019] [Indexed: 12/31/2022]
Abstract
Surgery for retroperitoneal sarcomas should be "en bloc" compartmental, which involves resection of unaffected organs. Its upfront use is key, providing a high percentage of resections with negative margins, resulting in a better local control and increased survival in many patients. Preservation of organs should be done in an individualized manner, especially in the pelvic location, and adapted to the histological aggressiveness of the tumor. Preoperative biopsy is able to establish the diagnosis of sarcoma subtype and consequently an adequate perioperative strategy. These patients should be managed by expert surgeons at referral centers with multidisciplinary units and oncology committees. The use of chemotherapy and radiotherapy is not yet well defined, so it is only recommended at referral centers with clinical trials. Currently, this is the only option to offer the best morbidity and mortality rates, as well as possible improvements in the survival of these patients.
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Affiliation(s)
| | | | | | | | | | | | - Alicia Lozano Borbalas
- Oncología Radioterápica, Institut Català d'Oncologia, Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, España
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Artigas Raventós V. Tumores mesenquimales-sarcomas: un nuevo grupo de trabajo en la Asociación Española de Cirujanos. Cir Esp 2018; 96:527-528. [DOI: 10.1016/j.ciresp.2018.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 03/01/2018] [Indexed: 02/01/2023]
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Artigas Raventós V, Rivero Cruces D, González López J, Rodríguez Blanco M, Boguña I. Aggressive angiomyxoma. A rare mesenchymal pelvic tumor. Cir Esp 2016; 94:359-61. [PMID: 26980258 DOI: 10.1016/j.ciresp.2016.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 01/13/2016] [Accepted: 01/24/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Vicente Artigas Raventós
- Unidad de Cirugía HBP-Oncológica, Servicio de Cirugía General y Digestiva, Hospital Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España.
| | - Diego Rivero Cruces
- Unidad de Cirugía HBP-Oncológica, Servicio de Cirugía General y Digestiva, Hospital Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | - José González López
- Unidad de Cirugía HBP-Oncológica, Servicio de Cirugía General y Digestiva, Hospital Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | - Manuel Rodríguez Blanco
- Unidad de Cirugía HBP-Oncológica, Servicio de Cirugía General y Digestiva, Hospital Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | - Isidre Boguña
- Unidad de Cirugía Onco-Ginecológica, Hospital Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
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Gonzalez Lopez JA, Artigas Raventós V, Rodríguez Blanco M, Lopez-Pousa A, Bagué S, Abellán M, Trias Folch M. Diferencias entre cirugía en bloque y enucleación en el tratamiento del sarcoma retroperitoneal. Cir Esp 2014; 92:525-31. [DOI: 10.1016/j.ciresp.2014.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 01/28/2014] [Accepted: 02/06/2014] [Indexed: 10/25/2022]
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Cuevas Herreros Ó, Escobar Lezcano L, Rodriguez Blaco M, Artigas Raventós V. PEComa, a rare epithelioid cell tumor. Cir Esp 2014; 93:e65-7. [PMID: 24560632 DOI: 10.1016/j.ciresp.2013.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 07/10/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Óscar Cuevas Herreros
- Servicio de Cirugía Cardiaca, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | - Lilian Escobar Lezcano
- Servicio Cirugía General y Digestiva, Hospital de la Santa Creu i Sant Pau, Univertsitat Autònoma, Barcelona, España
| | - Manuel Rodriguez Blaco
- Servicio Cirugía General y Digestiva, Hospital de la Santa Creu i Sant Pau, Univertsitat Autònoma, Barcelona, España
| | - Vicente Artigas Raventós
- Servicio Cirugía General y Digestiva, Hospital de la Santa Creu i Sant Pau, Univertsitat Autònoma, Barcelona, España
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Mocanu SN, González López JA, Villalba Auñón J, Artigas Raventós V. [Percutaneous treatment of a tumour obstruction of the afferent loop of a hepaticojejunostomy]. Cir Esp 2012; 92:209-10. [PMID: 23219420 DOI: 10.1016/j.ciresp.2012.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 05/28/2012] [Indexed: 02/07/2023]
Affiliation(s)
- Sorin Niky Mocanu
- Servicio de Cirugía General y Digestiva, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | | | - Jordi Villalba Auñón
- Servicio de Radiodiagnóstico, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - Vicente Artigas Raventós
- Servicio de Cirugía General y Digestiva, Hospital de la Santa Creu i Sant Pau, Barcelona, España
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Artigas Raventós V, López Pousa A, Ortega Medina L, Díaz de Liaño Argüelles A, Fernández Hernández JÁ, Lucena de la Poza JL. [Primary, non-metastatic gastrointestinal stromal tumour surgery: results of the GRISK study]. Cir Esp 2012; 91:96-102. [PMID: 22748847 DOI: 10.1016/j.ciresp.2012.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 04/23/2012] [Accepted: 05/07/2012] [Indexed: 01/07/2023]
Abstract
INTRODUCTION AND OBJECTIVES Radical surgery is the standard treatment for localised gastrointestinal stromal tumours (GIST). A series of primary GIST, their treatment and pre-established risk of recurrence after their follow-up is evaluated. MATERIAL AND METHODS A retrospective, descriptive and multicentre study was conducted on primary, non-metastatic GIST operated on between June 2007 and December 2008. The variables of greater relevance were analysed, including, location, size, mitotic index, and NHI and AFIP recurrence prognostic criteria, and their correlation with the disease-free survival (DFS) of the patients. RESULTS The series included 141 patients with a mean age of 65 years. The most frequent GIST location was in the stomach (70.8%) and small intestine (22.9%), and with a mean tumour size of 6.7 cm (0.5-35 cm). The surgery was R0 in 97.2% of cases (laparoscopic approach, 21.5%). The distribution according to NHI/Flescher criteria was, high (31.95%), and intermediate (26.4%), and according to AFIP/Miettinen criteria it was, high (22.9%) and intermediate (12.5%). After a mean follow-up of 20.3 months, there was a 7.1% (10 cases) recurrence, with only 2 cases belonging to the group with a «low risk» using the NHI and AFIP prognostic criteria. The DFS at one year was 95.5% and 91.5% at 2 years. CONCLUSIONS The series showed a high DFS and a good correlation with both the Flescher and the Miettinen criteria. However, the risk of recurrence varied according to the AFIP criteria (intermediate/high, 58.3%), or the AFIP criteria (intermediate/high, 35.4%) which included the tumour location. For this reason, we consider these latter criteria as the most adequate for assessing the prognostic risk of GIST recurrence.
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Affiliation(s)
- Vicente Artigas Raventós
- Unidad de Cirurgia HBP/Oncològica, Servei de Cirurgia General i Digestiva, Hospital Santa Creu i Sant Pau, UAB, Barcelona.
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Mocanu SN, Artigas Raventós V, Rodríguez Blanco M, Farré Viladrich A, Trias Folch M. [Idiopathic fibrosing pancreatitis-a uncommon cause of obstructive jaundice in young patients]. Cir Esp 2012; 91:271-4. [PMID: 22541447 DOI: 10.1016/j.ciresp.2011.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Revised: 07/14/2011] [Accepted: 08/12/2011] [Indexed: 11/17/2022]
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Mocanu SN, Rodríguez Blanco M, Palmer Sancho J, Artigas Raventós V. [Hepatic subcapsular biloma secondary to laparoscopic cholecystectomy]. Cir Esp 2011; 90:e41. [PMID: 22192519 DOI: 10.1016/j.ciresp.2011.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 10/03/2011] [Indexed: 11/30/2022]
Affiliation(s)
- Sorin Niky Mocanu
- Servicio de Cirugía General y Digestiva, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
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Magarzo García J, Moral Duarte A, Serrano Escobedo A, Chierichetti Asan C, Artigas Raventós V, Trias Folch M. Perforación intestinal por anisakiasis. Cir Esp 2002. [DOI: 10.1016/s0009-739x(02)72074-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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