How to treat retroperitoneal lymphoma

The harm caused by retroperitoneal lymphoma is relatively large, so in order to reduce the impact of these diseases, scientific treatment and surgical treatment are more common, especially when serious complications such as bleeding or obstruction occur, surgical treatment should be emphasized.

1. Surgical treatment

The main surgical treatment for retroperitoneal tumors is surgical resection, which is the best way for patients to obtain potential cure. The principle of surgical resection is to perform standardized radical resection (R0 resection) as much as possible while ensuring safety. In recent years, with the improvement of knowledge, more scholars advocate compartment resection (Compartment Resection) for retroperitoneal malignant tumors to achieve better radical cure effect. Literature reports that this more extensive resection can reduce the 5-year recurrence rate after resection from 50% to 20%, and the 5-year survival rate can reach more than 70%.

Retroperitoneal tumors are prone to repeated local recurrences, and patients often undergo multiple surgeries, with the interval between recurrences gradually shortening until they are no longer able to undergo surgery. Therefore, in addition to paying attention to the radicality of the first surgery, patients also need to find the appropriate time for surgery when recurrence occurs.

2. Interventional treatment

Intervention can not only help understand the blood supply of the tumor before surgery, but also perform selective blood supply artery embolization therapy for retroperitoneal tumors with rich arterial blood supply and large tumors to reduce the risk of intraoperative bleeding, or promote the establishment of collateral circulation, reduce the impact of tumor removal on hemodynamics, and thus reduce surgical risks. When a retroperitoneal tumor ruptures and bleeds, emergency hemostasis is required but surgery is not possible, interventional embolization or balloon occlusion of the tumor blood vessels can be tried to buy time and create conditions for further treatment.

3. Systemic treatment

Except for a few retroperitoneal tumors such as lymphoma that are sensitive to chemotherapy, there are no chemotherapy drugs with significant efficacy for most retroperitoneal tumors. Although doxorubicin, dacarbazine, gemcitabine, etc. show certain application prospects, large-sample clinical trials are still needed.

4. Multidisciplinary team (MDT)

Due to the particularity of retroperitoneal tumors in terms of biological characteristics, pathological types, etc., the role of multidisciplinary collaboration is particularly important. During the diagnosis and treatment process, a multidisciplinary team composed of personnel from surgery, internal medicine, radiotherapy, intervention, imaging and scientific research will discuss relevant cases together and comprehensively plan the most suitable individualized treatment plan for the patient, so that the patient can receive the most reasonable treatment.