Updated Review and Clinical Recommendations for the Diagnosis and Treatment of Patients with Retroperitoneal Sarcoma by the Spanish Sarcoma Research Group (GEIS).

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.

Review of the treatment of liver hydatid cysts.

UNLABELLED: A review was carried out in Medline, LILACS and the Cochrane Library. Our database search strategy included the following terms: "hydatid cyst", "liver", "management", "meta-analysis" and "randomized controlled trial". No language limits were used in the literature search. The latest electronic search date was the 7(th) of January 2014. INCLUSION AND EXCLUSION CRITERIA: all relevant studies on the assessment of therapeutic methods for hydatid cysts of the liver were considered for analysis. Information from editorials, letters to publishers, low quality review articles and studies done on animals were excluded from analysis. Additionally, well-structured abstracts from relevant articles were selected and accepted for analysis. Standardized forms were designed for data extraction; two investigators entered the data on patient demographics, methodology, recurrence of HC, mean cyst size and number of cysts per group. Four hundred and fourteen articles were identified using the previously described search strategy. After applying the inclusion and exclusion criteria detailed above, 57 articles were selected for final analysis: one meta-analysis, 9 randomized clinical trials, 5 non-randomized comparative prospective studies, 7 non-comparative prospective studies, and 34 retrospective studies (12 comparative and 22 non-comparative). Our results indicate that antihelminthic treatment alone is not the ideal treatment for liver hydatid cysts. More studies in the literature support the effectiveness of radical treatment compared with conservative treatment. Conservative surgery with omentoplasty is effective in preventing postoperative complications. A laparoscopic approach is safe in some situations. Percutaneous drainage with albendazole therapy is a safe and effective alternative treatment for hydatid cysts of the liver. Radical surgery with pre- and post-operative administration of albendazole is the best treatment option for liver hydatid cysts due to low recurrence and complication rates.

Reflexiones sobre 250 intervenciones de metástasis hepáticas de carcinoma colorrectal / Reflections on 250 interventions for colorectal carcinoma metastases to the liver

Introducción. Los mejores resultados en el tratamiento de las metástasis hepáticas de carcinoma colorrectal se obtienen con la resección quirúrgica, que debe realizarse con unos estándares de calidad. Objetivos. Presentar la experiencia de 11 años en el tratamiento quirúrgico de las metástasis hepáticas de carcinoma colorrectal en una unidad de referencia y comprobar si se cumplen los estándares actuales de calidad. Pacientes y método. Desde enero de 1995 hasta diciembre de 2005 se realizaron 250 intervenciones en 221 pacientes diagnosticados de metástasis hepáticas de origen colorrectal, con 201 resecciones hepáticas. Resultados. El 19% de los pacientes tenían una edad ≥ 70 años, con factores comórbidos asociados en el 54% de los casos. De las 201 resecciones, el 8,5% fue una segunda resección. En el 39% se realizó una hepatectomía mayor. La resección fue R0 en el 85% de los casos. No se transfundió en el 80% de los casos. La mediana de estancia postoperatoria fue de 6 días, la mortalidad postoperatoria fue del 0% y la morbilidad, del 19%. Se relacionaron con la morbilidad el número de segmentos resecados y la transfusión peroperatoria. Las supervivencias actuariales generales a 1, 3 y 5 años fueron del 96, el 69 y el 52% y las supervivencias actuariales libres de enfermedad para los mismos períodos fueron del 58, el 32 y el 24%, respectivamente. Conclusiones. La resección de las metástasis hepáticas de carcinoma colorrectal es una buena opción terapéutica cuando se cumplen los estándares de calidad actuales (AU)

Introduction. The best results in the treatment of colorectal cancer metastases to the liver are currently achieved with surgical resection performed under high quality standards. Objectives. To analyze the results and quality standards of the surgical treatment of colorectal cancer liver metastases in a referral liver unit over an 11-year period. Patients and method. From January 1995 to December 2005, 250 surgical interventions were performed in 221 patients diagnosed with colorectal cancer liver metastases, resulting in 201 hepatic resections. Results. Nineteen percent of patients were ≥ 70 years old and comorbidity was present in 54%. Of the 201 hepatic resections, 8.5% were second resections. Major hepatectomy was performed in 39% of the patients. R0 resection was achieved in 85% of the patients. Blood transfusions were not required in 80% of the patients. The median length of postoperative stay was 6 days. Postoperative mortality was nil and morbidity was 19%. Morbidity was associated with the number of resected segments and the need for blood transfusion. The estimated 1-, 3- and 5-year cumulative survival rates were 96%, 69% and 52%, respectively, while estimated disease-free survival rates were 58%, 32% and 24%, respectively. Conclusions. Resection of colorectal cancer liver metastases is an effective therapeutic alternative if high current quality standards are achieved (AU)