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Consensus Guidelines on Perioperative Care in Primary Retroperitoneal Sarcoma Surgery
Pablo Lozano Lominchar1, Óscar Díaz-Cambronero2, Paula Muñoz-Muñoz3
1Department of General Surgery and Surgical Oncology, Hospital General Universitario Gregorio Maranon. IISGM, Madrid, Spain.
Annals of Surgical Oncology
|April 13, 2026
Summary
This study establishes the first consensus-based guidelines for perioperative care in primary retroperitoneal sarcomas (RPS) surgery. These recommendations aim to standardize treatment and improve outcomes for patients undergoing this complex procedure.
Area of Science:
- Surgical Oncology
- Multidisciplinary Care
Background:
- Primary retroperitoneal sarcomas (RPS) are rare, aggressive malignancies.
- Standardized Enhanced Recovery After Surgery (ERAS) protocols are lacking for RPS.
- Expert consensus is needed to optimize perioperative management.
Purpose of the Study:
- To develop consensus-based guidelines for perioperative care in primary RPS surgery.
- To standardize clinical practice and reduce outcome variability.
- To improve surgical and recovery outcomes for high-risk RPS patients.
Main Methods:
- A multidisciplinary expert panel was convened.
- A modified Delphi process was employed, including literature review and structured voting.
- Recommendations were graded using the GRADE framework, with consensus defined as ≥80% agreement.
Main Results:
- 42 recommendations were proposed covering preoperative, intraoperative, and postoperative care.
- 33 recommendations achieved consensus (17 weak, 16 strong).
- Recommendations addressed anemia, nutrition, fluid therapy, analgesia, and mobilization, often supported by evidence from related surgical fields.
Conclusions:
- These are the first multidisciplinary, consensus-based guidelines for primary RPS perioperative care.
- The guidelines aim to harmonize practice and enhance patient outcomes.
- Further prospective validation and international collaboration are recommended.
