Management of Primary Retroperitoneal Sarcoma (RPS) in the Adult: An Updated Consensus Approach from the Transatlantic Australasian RPS Working Group
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 o...
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Published in: | Annals of surgical oncology Vol. 28; no. 12; pp. 7873 - 7888 |
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Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format: | Journal Article |
Language: | English |
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Springer International Publishing
01-11-2021
Springer Nature B.V |
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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. |
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AbstractList | 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. 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. 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. 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. 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. BackgroundRetroperitoneal 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.MethodsThe 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.ResultsManagement 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.ConclusionsOngoing 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. |
Author | van Houdt, Winan J. Rutkowski, Piotr Haas, Rick L. Gronchi, Alessandro Raut, Chandrajit P. Snow, Hayden Desai, Anant Smith, Myles J. Jones, Robin L. Mullinax, John E. DeLaney, Thomas Bouhadiba, Toufik Fiore, Marco Gyorki, David E. Stoeckle, Eberhard Gonzalez, Ricardo Tzanis, Dimitri Skoczylas, Jacek Fairweather, Mark Albertsmeier, Markus Cardona, Kenneth Callegaro, Dario Ng, Deanna Strauss, Dirk C. Bonvalot, Sylvie Swallow, Carol J. Ford, Samuel J. Park, Jae Berm Stacchiotti, Silvia Roland, Christina L. Hayes, Andrew Gladdy, Rebecca A. Nessim, Carolyn |
AuthorAffiliation | 3 Sarcoma Unit, Department of Academic Surgery, Royal Marsden Hospital, Royal Marsden NHS Foundation Trust, London, UK 6 Department of Surgery, University Hospitals Birmingham, Birmingham, UK 15 Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA 9 Department of Surgery, Brigham and Women’s Hospital, Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 13 Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-Universität, University Hospital, Munich, Germany 18 Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy 20 Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 4 Department of Surgical Oncology, Institut Curie, PSL University, Paris, France 1 Department of Surgical Oncology, Princess Margaret Cancer Centre/Mount Sinai Hospital, Toronto, ON, Canada 10 Department of Surgical Oncology, The Netherlands Ca |
AuthorAffiliation_xml | – name: 7 Sarcoma Department, H. Lee Moffitt Cancer Center, Tampa, FL – name: 14 Department of Surgery, University of Ottawa, Ottawa, ON, Canada – name: 18 Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy – name: 6 Department of Surgery, University Hospitals Birmingham, Birmingham, UK – name: 15 Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA – name: 20 Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA – name: 17 Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands – name: 8 Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia – name: 13 Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-Universität, University Hospital, Munich, Germany – name: 2 Department of Surgery, University of Toronto, Toronto, ON, Canada – name: 5 Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland – name: 1 Department of Surgical Oncology, Princess Margaret Cancer Centre/Mount Sinai Hospital, Toronto, ON, Canada – name: 19 Department of Medical Oncology, Royal Marsden NHS Foundation Trust, London, UK – name: 12 Department of Surgery, Samsung Medical Center, Seoul, South Korea – name: 9 Department of Surgery, Brigham and Women’s Hospital, Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA – name: 16 Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy – name: 21 Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX – name: 4 Department of Surgical Oncology, Institut Curie, PSL University, Paris, France – name: 10 Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands – name: 11 Department of Surgery, Institut Bergonie, Bordeaux, France – name: 3 Sarcoma Unit, Department of Academic Surgery, Royal Marsden Hospital, Royal Marsden NHS Foundation Trust, London, UK |
Author_xml | – sequence: 1 givenname: Carol J. surname: Swallow fullname: Swallow, Carol J. email: Carol.Swallow@sinaihealth.ca organization: Department of Surgical Oncology, Princess Margaret Cancer Centre/Mount Sinai Hospital, Department of Surgery, University of Toronto – sequence: 2 givenname: Dirk C. surname: Strauss fullname: Strauss, Dirk C. email: dirk.strauss@rmh.nhs.uk organization: Sarcoma Unit, Department of Academic Surgery, Royal Marsden Hospital, Royal Marsden NHS Foundation Trust – sequence: 3 givenname: Sylvie surname: Bonvalot fullname: Bonvalot, Sylvie organization: Department of Surgical Oncology, Institut Curie, PSL University – sequence: 4 givenname: Piotr surname: Rutkowski fullname: Rutkowski, Piotr organization: Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology – sequence: 5 givenname: Anant surname: Desai fullname: Desai, Anant organization: Department of Surgery, University Hospitals Birmingham – sequence: 6 givenname: Rebecca A. surname: Gladdy fullname: Gladdy, Rebecca A. organization: Department of Surgical Oncology, Princess Margaret Cancer Centre/Mount Sinai Hospital, Department of Surgery, University of Toronto – sequence: 7 givenname: Ricardo surname: Gonzalez fullname: Gonzalez, Ricardo organization: Sarcoma Department, H. Lee Moffitt Cancer Center – sequence: 8 givenname: David E. surname: Gyorki fullname: Gyorki, David E. organization: Department of Cancer Surgery, Peter MacCallum Cancer Centre – sequence: 9 givenname: Mark surname: Fairweather fullname: Fairweather, Mark organization: Department of Surgery, Brigham and Women’s Hospital, Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School – sequence: 10 givenname: Winan J. surname: van Houdt fullname: van Houdt, Winan J. organization: Department of Surgical Oncology, The Netherlands Cancer Institute – sequence: 11 givenname: Eberhard surname: Stoeckle fullname: Stoeckle, Eberhard organization: Department of Surgery, Institut Bergonie – sequence: 12 givenname: Jae Berm surname: Park fullname: Park, Jae Berm organization: Department of Surgery, Samsung Medical Center – sequence: 13 givenname: Markus surname: Albertsmeier fullname: Albertsmeier, Markus organization: Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-Universität, University Hospital – sequence: 14 givenname: Carolyn surname: Nessim fullname: Nessim, Carolyn organization: Department of Surgery, University of Ottawa – sequence: 15 givenname: Kenneth surname: Cardona fullname: Cardona, Kenneth organization: Department of Surgery, Winship Cancer Institute, Emory University – sequence: 16 givenname: Marco surname: Fiore fullname: Fiore, Marco organization: Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori – sequence: 17 givenname: Andrew surname: Hayes fullname: Hayes, Andrew organization: Sarcoma Unit, Department of Academic Surgery, Royal Marsden Hospital, Royal Marsden NHS Foundation Trust – sequence: 18 givenname: Dimitri surname: Tzanis fullname: Tzanis, Dimitri organization: Department of Surgical Oncology, Institut Curie, PSL University – sequence: 19 givenname: Jacek surname: Skoczylas fullname: Skoczylas, Jacek organization: Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology – sequence: 20 givenname: Samuel J. surname: Ford fullname: Ford, Samuel J. organization: Department of Surgery, University Hospitals Birmingham – sequence: 21 givenname: Deanna surname: Ng fullname: Ng, Deanna organization: Department of Surgical Oncology, Princess Margaret Cancer Centre/Mount Sinai Hospital, Department of Surgery, University of Toronto – sequence: 22 givenname: John E. surname: Mullinax fullname: Mullinax, John E. organization: Sarcoma Department, H. Lee Moffitt Cancer Center – sequence: 23 givenname: Hayden surname: Snow fullname: Snow, Hayden organization: Department of Cancer Surgery, Peter MacCallum Cancer Centre – sequence: 24 givenname: Rick L. surname: Haas fullname: Haas, Rick L. organization: Department of Radiation Oncology, The Netherlands Cancer Institute – sequence: 25 givenname: Dario surname: Callegaro fullname: Callegaro, Dario organization: Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori – sequence: 26 givenname: Myles J. surname: Smith fullname: Smith, Myles J. organization: Sarcoma Unit, Department of Academic Surgery, Royal Marsden Hospital, Royal Marsden NHS Foundation Trust – sequence: 27 givenname: Toufik surname: Bouhadiba fullname: Bouhadiba, Toufik organization: Department of Surgical Oncology, Institut Curie, PSL University – sequence: 28 givenname: Silvia surname: Stacchiotti fullname: Stacchiotti, Silvia organization: Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori – sequence: 29 givenname: Robin L. surname: Jones fullname: Jones, Robin L. organization: Department of Medical Oncology, Royal Marsden NHS Foundation Trust – sequence: 30 givenname: Thomas surname: DeLaney fullname: DeLaney, Thomas organization: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School – sequence: 31 givenname: Christina L. surname: Roland fullname: Roland, Christina L. organization: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center – sequence: 32 givenname: Chandrajit P. surname: Raut fullname: Raut, Chandrajit P. organization: Department of Surgery, Brigham and Women’s Hospital, Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School – sequence: 33 givenname: Alessandro surname: Gronchi fullname: Gronchi, Alessandro email: alessandro.gronchi@istitutotumori.mi.it organization: Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33852100$$D View this record in MEDLINE/PubMed |
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ContentType | Journal Article |
Copyright | Society of Surgical Oncology 2021 Society of Surgical Oncology 2021. |
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CorporateAuthor | Transatlantic Australasian RPS Working Group (TARPSWG) on behalf of the Transatlantic Australasian RPS Working Group (TARPSWG) |
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DOI | 10.1245/s10434-021-09654-z |
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PublicationTitle | Annals of surgical oncology |
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Retroperitoneal soft tissue sarcomas comprise a heterogeneous group of rare tumors of mesenchymal origin that include several well-defined... Retroperitoneal soft tissue sarcomas comprise a heterogeneous group of rare tumors of mesenchymal origin that include several well-defined histologic subtypes.... BackgroundRetroperitoneal soft tissue sarcomas comprise a heterogeneous group of rare tumors of mesenchymal origin that include several well-defined histologic... |
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SubjectTerms | Clinical trials Collaboration Gastric cancer Malignancy Management Medicine Medicine & Public Health Mesenchyme Oncology Sarcoma Surgery Surgical Oncology Tumors Working groups |
Title | Management of Primary Retroperitoneal Sarcoma (RPS) in the Adult: An Updated Consensus Approach from the Transatlantic Australasian RPS Working Group |
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