腹膜后肉瘤（RPS）是一组罕见且异质的恶性肿瘤，给评估和治疗带来了重大挑战。手术是 RPS 治疗的基石，关键取决于完全切除才能获得良好的预后。切除范围是局部控制和生存的关键决定因素。本综述深入探讨了局部 RPS 多学科管理的演变，强调了根据肿瘤组织学、位置和患者功能状态调整手术策略的必要性。我们探讨了隔室手术的原理（一种扩展的一线方法，涉及切除邻近内脏以获得广泛的阴性切缘）及其在不同 RPS 组织学亚型和其他类型的更有限切除中的有效性。特别强调疾病的异质性，因为各种组织学亚型表现出不同的生物学行为。这就需要改变一刀切的治疗方法。该综述分析了不同手术策略的作用，重点关注组织学类型和位置。此外，还检查了（新）辅助治疗（例如放疗和化疗）的潜在益处，认识到其特定的组织学适应症和局限性。这篇全面的综述整合了有关手术策略和补充疗法的最新数据，倡导针对组织学量身定制的个性化方法。随着对 RPS 分子和遗传基础的了解不断发展，其有效管理策略也不断发展，强调了该领域专家之间需要进行全球合作，以增强我们的集体知识和治疗方法。版权所有 © 2024 Garcia-Ortega。

Retroperitoneal sarcoma (RPS) represents a rare and heterogeneous group of malignancies, posing significant challenges in evaluation and management. Surgery, the cornerstone of RPS treatment, critically depends on complete resection for a favorable prognosis. The extent of resection is a crucial determinant of local control and survival. This review delves into the evolution of multidisciplinary management of localized RPS, highlighting the imperative to adapt surgical strategies to tumor histology, location, and patient functional status. We explore the principles of compartmental surgery-an extended first-line approach that involves resecting adjacent viscera for wide negative margins-and its effectiveness across different histological subtypes of RPS and more limited resections for other types. Particular emphasis is placed on the heterogeneity of the disease, as various histological subtypes exhibit distinct biological behaviors. This necessitates a shift away from a one-size-fits-all treatment approach. The review analyzes the role of different surgical strategies, focusing on histological type and location. Additionally, the potential benefits of (neo)adjuvant treatments, such as radiotherapy and chemotherapy, are examined, recognizing their specific histological indications and limitations. This comprehensive review consolidates recent data on surgical strategies and complementary therapies, advocating for a personalized approach tailored to histology. As understanding of the molecular and genetic underpinnings of RPS continues to evolve, so will strategies for its effective management, underscoring the need for global collaboration among specialists in this field to enhance our collective knowledge and treatment methodologies.Copyright © 2024 Garcia-Ortega.