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
Main Authors: Swallow, Carol J., Strauss, Dirk C., Bonvalot, Sylvie, Rutkowski, Piotr, Desai, Anant, Gladdy, Rebecca A., Gonzalez, Ricardo, Gyorki, David E., Fairweather, Mark, van Houdt, Winan J., Stoeckle, Eberhard, Park, Jae Berm, Albertsmeier, Markus, Nessim, Carolyn, Cardona, Kenneth, Fiore, Marco, Hayes, Andrew, Tzanis, Dimitri, Skoczylas, Jacek, Ford, Samuel J., Ng, Deanna, Mullinax, John E., Snow, Hayden, Haas, Rick L., Callegaro, Dario, Smith, Myles J., Bouhadiba, Toufik, Stacchiotti, Silvia, Jones, Robin L., DeLaney, Thomas, Roland, Christina L., Raut, Chandrajit P., Gronchi, Alessandro
Format: Journal Article
Language:English
Published: Cham 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.
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
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  surname: Swallow
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  email: Carol.Swallow@sinaihealth.ca
  organization: Department of Surgical Oncology, Princess Margaret Cancer Centre/Mount Sinai Hospital, Department of Surgery, University of Toronto
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  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
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  organization: Department of Surgical Oncology, Institut Curie, PSL University
– sequence: 4
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  surname: Desai
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  organization: Department of Surgery, University Hospitals Birmingham
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  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
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  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
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  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
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  surname: Snow
  fullname: Snow, Hayden
  organization: Department of Cancer Surgery, Peter MacCallum Cancer Centre
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  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
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  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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Snippet Background 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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Publisher
StartPage 7873
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
URI https://link.springer.com/article/10.1245/s10434-021-09654-z
https://www.ncbi.nlm.nih.gov/pubmed/33852100
https://www.proquest.com/docview/2582283212
https://pubmed.ncbi.nlm.nih.gov/PMC9257997
Volume 28
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