[Extraperitoneal XXXX : chemo-radiotherapy treatments].

@entity5 @entity1 @entity3 @entity2802
PURPOSE: The determination of the best therapeutic approach in extraperitoneal @entity5 @entity1 is very complex both in the neoadjuvant/adjuvant and the metastatic setting. We tried to identify and summarize the current methods of diagnosis, staging and treatment from a multidisciplinary approach. METHODS: Five sections can be indentified: diagnosis and staging; neoadjuvant treatment; adjuvant treatment; liver metastases treatment and local recurrence therapy Data were collected from international guidelines (NCCN) and MEDLINE search. The main aim was the identification of the beast diagnostic and therapeutic approach in extraperitoneal @entity5 @entity1 in case of local recurrence and @entity3 . RESULTS: Data from 2010 NCCN guidelines and 48 articles published in major international oncologic reviews were collected and evaluated from 1993 up to 2009. Three articles dealt with staging procedures, 24 dealt with neoadjuvant and adjuvant therapy; 18 were about with liver metastases and 3 about local recurrence treatment. CONCLUSIONS: The correct disease staging is necessary for pursuing the best therapeutic approach and it should involve different radiological techniques in order to evaluate the clinic @entity2802 . Neoadjuvant treatment (chemo-radiotherapy) should be considered for stage II and stage III extraperitoneal @entity5 @entity1 , followed by post-operative adjuvant chemotherapy. @entity1 who underwent surgery and have a @entity5 , have to receive four months of adjuvant chemotherapy after surgical resection. Initial treatment options of asymptomatic @entity1 with resectable liver metases include systemic chemotherapy in' order to obtain downstaging of the @entity5 and liver metastase shrinking followed by resection. The treatment of local recurrence is mainly surgical. If not previously administered, radiotherapy represents an alternative therapeutic treatment.
