On the occasion of the Joint Congress of the Scientific Societies of Surgery, in Rome from 14 to 18 October, Professor Vittorio Quagliuolo – Head of the General Oncological Surgery Unit of Humanitas – presented to the audience of experts the Biennial Report entitled “News in the treatment of retroperitoneal sarcomas”.
The event is the most important at the national level as it sees the participation of more than thirty Italian surgical companies from different specialties and branches of surgery, with the presence of more than 3,500 surgeons and experts from all over Italy and abroad.
The reading of the Biennial Report in front of this audience was undoubtedly an acknowledgement of the work and research of Professor Quagliuolo, who has always dealt with sarcomas and in particular retroperitoneal sarcomas.
The report, which is assigned by the Steering Committee of the Italian Society of Surgery, is followed by the publication of a monograph, a text that becomes a de facto part of the scientific literature. Springer, a publishing house specializing in the publication of scientific and medical journals and works, has published the monograph “Current treatment of retroperitoneal sarcomas. A joint effort with the Italian Society of Surgical Oncology”, of which Professor Quagliuolo himself is editor together with his colleague Alessandro Gronchi, of the Istituto Nazionale dei Tumori.
The surgery of retroperitoneal sarcomas: how it has changed in recent years
“Sarcomas affecting the retroperitoneum are an extremely rare disease, equal to 16% of all cases of sarcomas, it is about 400 new patients per year,” explained Professor Quagliuolo. “It is an area that in recent years has made many steps forward compared to the past, when it was a subject of study that did not give great satisfaction from the point of view of results in terms of oncological outcome, while today arouses much interest from the scientific community.
“Until the 2000s, retroperitoneal sarcomas were burdened by a very high percentage of local recurrences – added the professor: the overall survival of patients with this disease was around 30% at 10 years after surgery, with 50% of local recurrences at 5 years, so one in two patients fell with a local recurrence and only one in three survived sarcoma.
“For this reason it was decided to change surgical strategy and move from a conservative to a more demolitive surgery,” explained Quagliuolo ” An approach in contrast to what has developed in recent decades with surgical treatments meaning more conservative as in the case of breast, rectum, cervical-facial surgery and that for limb sarcomas.
“Once upon a time, retroperitoneal surgery aimed to preserve the surrounding organs that came into contact with the tumor, such as the colon, kidneys, pancreas or psoas muscle as much as possible, while now they are involved in the removal of principle, regardless of whether they are evidently infiltrated by sarcomas or not,” explained the professor making it clear that “this choice must be shared and accepted by patients, explaining to them that although it is a very challenging and demolishing surgery the results in terms of survival and benefit in the long term are significant”.
With this surgical strategy the overall survival at 10 years has increased from 30% to 50% of cases, while the appearance of local recurrences at 5 years has decreased from 50% to 23%. Mortality and postoperative complications are also contained.