Carol J Swallow1,2, Dirk C Strauss3, Sylvie Bonvalot4, Piotr Rutkowski5, Anant Desai6, Rebecca A Gladdy7,8, Ricardo Gonzalez9, David E Gyorki10, Mark Fairweather11, Winan J van Houdt12, Eberhard Stoeckle13, Jae Berm Park14, Markus Albertsmeier15, Carolyn Nessim16, Kenneth Cardona17, Marco Fiore18, Andrew Hayes19, Dimitri Tzanis4, Jacek Skoczylas5, Samuel J Ford6, Deanna Ng7,8, John E Mullinax9, Hayden Snow10, Rick L Haas20, Dario Callegaro18, Myles J Smith19, Toufik Bouhadiba4, Silvia Stacchiotti21, Robin L Jones22, Thomas DeLaney23, Christina L Roland24, Chandrajit P Raut11, Alessandro Gronchi25. 1. Department of Surgical Oncology, Princess Margaret Cancer Centre/Mount Sinai Hospital, Toronto, ON, Canada. Carol.Swallow@sinaihealth.ca. 2. Department of Surgery, University of Toronto, Toronto, ON, Canada. Carol.Swallow@sinaihealth.ca. 3. Sarcoma Unit, Department of Academic Surgery, Royal Marsden Hospital, Royal Marsden NHS Foundation Trust, London, UK. dirk.strauss@rmh.nhs.uk. 4. Department of Surgical Oncology, Institut Curie, PSL University, Paris, France. 5. Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland. 6. Department of Surgery, University Hospitals Birmingham, Birmingham, UK. 7. Department of Surgical Oncology, Princess Margaret Cancer Centre/Mount Sinai Hospital, Toronto, ON, Canada. 8. Department of Surgery, University of Toronto, Toronto, ON, Canada. 9. Sarcoma Department, H. Lee Moffitt Cancer Center, Tampa, FL, USA. 10. Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. 11. Department of Surgery, Brigham and Women's Hospital, Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA. 12. Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 13. Department of Surgery, Institut Bergonie, Bordeaux, France. 14. Department of Surgery, Samsung Medical Center, Seoul, South Korea. 15. Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-Universität, University Hospital, Munich, Germany. 16. Department of Surgery, University of Ottawa, Ottawa, ON, Canada. 17. Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA. 18. Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 19. Sarcoma Unit, Department of Academic Surgery, Royal Marsden Hospital, Royal Marsden NHS Foundation Trust, London, UK. 20. Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 21. Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 22. Department of Medical Oncology, Royal Marsden NHS Foundation Trust, London, UK. 23. Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. 24. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 25. Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. alessandro.gronchi@istitutotumori.mi.it.
Abstract
BACKGROUND: Retroperitoneal soft tissue sarcomas comprise a heterogeneous group of rare tumors of mesenchymal origin that include several well-defined histologic subtypes. In 2015, the Transatlantic Australasian RPS Working Group (TARPSWG) published consensus recommendations for the best management of primary retroperitoneal sarcoma (RPS). Since then, through international collaboration, new evidence and knowledge have been generated, creating the need for an updated consensus document. METHODS: The primary aim of this study was to critically evaluate the current evidence and develop an up-to-date consensus document on the approach to these difficult tumors. The resulting document applies to primary RPS that is non-visceral in origin, with exclusion criteria as previously described. The relevant literature was evaluated and an international group of experts consulted to formulate consensus statements regarding the best management of primary RPS. A level of evidence and grade of recommendation were attributed to each new/updated recommendation. RESULTS: Management of primary RPS was considered from diagnosis to follow-up. This rare and complex malignancy is best managed by an experienced multidisciplinary team in a specialized referral center. The best chance of cure is at the time of primary presentation, and an individualized management plan should be made based on the 29 consensus statements included in this article, which were agreed upon by all of the authors. Whenever possible, patients should be enrolled in prospective trials and studies. CONCLUSIONS: Ongoing international collaboration is critical to expand upon current knowledge and further improve outcomes of patients with RPS. In addition, prospective data collection and participation in multi-institution trials are strongly encouraged.
BACKGROUND: Retroperitoneal soft tissue sarcomas comprise a heterogeneous group of rare tumors of mesenchymal origin that include several well-defined histologic subtypes. In 2015, the Transatlantic Australasian RPS Working Group (TARPSWG) published consensus recommendations for the best management of primary retroperitoneal sarcoma (RPS). Since then, through international collaboration, new evidence and knowledge have been generated, creating the need for an updated consensus document. METHODS: The primary aim of this study was to critically evaluate the current evidence and develop an up-to-date consensus document on the approach to these difficult tumors. The resulting document applies to primary RPS that is non-visceral in origin, with exclusion criteria as previously described. The relevant literature was evaluated and an international group of experts consulted to formulate consensus statements regarding the best management of primary RPS. A level of evidence and grade of recommendation were attributed to each new/updated recommendation. RESULTS: Management of primary RPS was considered from diagnosis to follow-up. This rare and complex malignancy is best managed by an experienced multidisciplinary team in a specialized referral center. The best chance of cure is at the time of primary presentation, and an individualized management plan should be made based on the 29 consensus statements included in this article, which were agreed upon by all of the authors. Whenever possible, patients should be enrolled in prospective trials and studies. CONCLUSIONS: Ongoing international collaboration is critical to expand upon current knowledge and further improve outcomes of patients with RPS. In addition, prospective data collection and participation in multi-institution trials are strongly encouraged.
Authors: Sean M McBride; Chandrajit P Raut; Michelle Lapidus; Phillip M Devlin; Karen J Marcus; Monica Bertagnolli; Suzanne George; Elizabeth H Baldini Journal: Ann Surg Oncol Date: 2013-02-08 Impact factor: 5.344
Authors: Alessandro Gronchi; Stefano Ferrari; Vittorio Quagliuolo; Javier Martin Broto; Antonio Lopez Pousa; Giovanni Grignani; Umberto Basso; Jean-Yves Blay; Oscar Tendero; Robert Diaz Beveridge; Virginia Ferraresi; Iwona Lugowska; Domenico Franco Merlo; Valeria Fontana; Emanuela Marchesi; Davide Maria Donati; Elena Palassini; Emanuela Palmerini; Rita De Sanctis; Carlo Morosi; Silvia Stacchiotti; Silvia Bagué; Jean Michelle Coindre; Angelo Paolo Dei Tos; Piero Picci; Paolo Bruzzi; Paolo Giovanni Casali Journal: Lancet Oncol Date: 2017-05-09 Impact factor: 41.316
Authors: S Bonvalot; E Gaignard; E Stoeckle; P Meeus; G Decanter; S Carrere; C Honore; J B Delhorme; M Fau; D Tzanis; S Causeret; P Gimbergues; J M Guillois; B Meunier; A Le Cesne; F Ducimetiere; M Toulmonde; J Y Blay Journal: Ann Surg Oncol Date: 2019-05-07 Impact factor: 5.344
Authors: Marcus C B Tan; Murray F Brennan; Deborah Kuk; Narasimhan P Agaram; Cristina R Antonescu; Li-Xuan Qin; Nicole Moraco; Aimee M Crago; Samuel Singer Journal: Ann Surg Date: 2016-03 Impact factor: 12.969
Authors: Fabio Tirotta; Michael G Fadel; James Hodson; Alessandro Parente; Helene Wilkerson; L Max Almond; Samuel J Ford; Andrew J Hayes; Anant Desai; Dirk C Strauss Journal: Ann Surg Oncol Date: 2022-07-19 Impact factor: 4.339
Authors: William W Tseng; Carol J Swallow; Dirk C Strauss; Chandrajit P Raut; Alessandro Gronchi Journal: Ann Surg Oncol Date: 2022-06-28 Impact factor: 4.339
Authors: William W Tseng; Carol J Swallow; Dirk C Strauss; Sylvie Bonvalot; Piotr Rutkowski; Samuel J Ford; Ricardo J Gonzalez; Rebecca A Gladdy; David E Gyorki; Mark Fairweather; Kyo Won Lee; Markus Albertsmeier; Winan J van Houdt; Magalie Fau; Carolyn Nessim; Giovanni Grignani; Kenneth Cardona; Vittorio Quagliuolo; Valerie Grignol; Jeffrey M Farma; Elisabetta Pennacchioli; Marco Fiore; Andrew Hayes; Dimitri Tzanis; Jacek Skoczylas; Max L Almond; John E Mullinax; Wendy Johnston; Hayden Snow; Rick L Haas; Dario Callegaro; Myles J Smith; Toufik Bouhadiba; Anant Desai; Rachel Voss; Roberta Sanfilippo; Robin L Jones; Elizabeth H Baldini; Andrew J Wagner; Charles N Catton; Silvia Stacchiotti; Khin Thway; Christina L Roland; Chandrajit P Raut; Alessandro Gronchi Journal: Ann Surg Oncol Date: 2022-06-29 Impact factor: 4.339
Authors: Cara Lai; Jeremiah R Long; Brandon T Larsen; Jose M Iturregui; Benjamin K Wilke; Krista A Goulding Journal: Skeletal Radiol Date: 2022-10-18 Impact factor: 2.128