unfortunately retro peritoneal sarcoma carry poor prognosis ,but if we combined debulking surgery and chemotherapy it may improve the prognosis

Professor Hasanain Jasim.

Totally according to you, what it is about is facing challenges to improve the patient, wise is his reflection.

Greetings.

Dr.Martí

before operative resection assessment of of involvement of major retro peritoneal major vessels which may preclude resection (involvement of proximal sup. mesentric A. , or bilateral renal vessels involvement) up to 75% of pt. have involvement of abd. visceral organ like small or large bowel .again the only hope to this pt. is to combined debulking surgery,chemotherapy and radiotherapy as chemoradiothepy alone without debulking is rarely beneficial .and what about of adding intra peritoneal chemotheapy ?

with my best regard .

Completely agree with colleague Hasanain Jasim. Unfortunately it was not perfomed three years ago

Professors Dusko Jovanović and Hasanain Jasim

Strongly agree with, (Combined debulking surgery, chemotherapy and radiotherapy since chemoradiotherapy alone without cytoreduction is rarely beneficial.) And in relation to intraperitoneal chemotherapy, it is another variant to a challenge such as the clinical case that I present, really do everything in our power before leaving the sick.

Unconditional greetings

Dr. Martí.

Combined debulking surgery, chemotherapy and radiotherapy is the classic therapy to face this problem, but it is important what it is going on.

Thereby cancer. net says: Immunotherapy: There are many forms of immunotherapy. Inhibitors of immune checkpoints have become the focus of many investigations. These drugs are targeted monoclonal antibodies (proteins) that activate immune responses in the body by removing the brakes on the immune system. The molecules that are blocked have names, such as CTLA4, PD-1, PD-L1, OX40, LAG3 and TIM3. It was shown that this approach is useful for treating many types of cancer and in sarcoma research studies. T cell therapy with chimeric antigen receptors (chimeric antigen receptor, CAR) uses the white blood cells of a patient's blood to destroy cancer cells. The patient's cells are removed and then modified in a laboratory to have specific proteins called receptors. These receptors allow T cells to recognize cancer cells. The modified T cells are grown in large quantities in the laboratory and returned to the patient's body. Once they return to the patient's body, these T cells seek and destroy the cancer cells. This technique is more promising when there is a known target in the sarcoma, as in the case of synovial sarcoma and myxoid liposarcoma of round cells. Clinical trials are investigating this great but complex form of immunotherapy. Vaccines against specific sarcoma proteins or other molecules are also being studied, often together with inhibitors of immune checkpoints.

I know , this is not available in all centers but it is the path that will follow in the future

sincerly

Dr Aguirre.

Profesor Roberto Eduardo Aguirre Fernandez.

Realmente su respuesta es una disertación del tema,la he recomendado,además totalmente de acuerdo con usted,efectivamente el seguimiento de tratamiento que usted propone -"es el camino que seguirá en el futuro"-esta son sus conclusiones y muy sabias,le reitero las gracias .

Saludos afectuosos.

Dr.Martí.