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Retroperitoneal sarcoma (RS) is a relatively rare (around 0.3% of all tumors) and highly malignant tumor. These tumors are almost not sensitive to conservative treatment and require aggressive approaches. Endoscopic surgery is safe technique widely used in oncology. We performed a retrospective analysis of treatment of patients with RSs to assess rational use of endoscopic approaches in treatment of these tumors. Analysis of treatment of 691 patients with RSs that were treated in NCIU during the last 45 years was performed. Long term outcomes and used approaches were taken into account. Surgery was performed for 571 (82.6%) patients that also included combined surgeries for 233 patients (40.8%). Ipsilateral kidney was involved in combined resection most often (121 cases, 21.1%). Quantity of exploratory surgeries was 17.4%, the most common reason for cancelation of operation was involvement of vital structures (structures of liver ligament, vena cava inferior, abdominal aorta, iliac arteries etc.). Median 5 year overall survival (OS) was 50.2±3,6%. In the period from 2017 to 2021 39 patients underwent RSs resection endoscopically. Comparison of postoperative complications showed that in the group of laparoscopic approach it was significantly lower (p12 cm). Taking into account the permanent improvement of technologies that are used in surgical oncology, radical treatment for RSs should be performed in high volume centers who are experienced in modern methods for treatment of these patients. Moreover, further randomized trials are needed to assess the most safe and effective approach for treatment of patients with RSs.
Patsko et al. (Fri,) studied this question.