Erschienen in:
29.06.2022 | Sarcoma
Management of Locally Recurrent Retroperitoneal Sarcoma in the Adult: An Updated Consensus Approach from the Transatlantic Australasian Retroperitoneal Sarcoma Working Group
verfasst von:
William W. Tseng, MD, Carol J. Swallow, MD, PhD, Dirk C. Strauss, MD, Sylvie Bonvalot, MD, PhD, Piotr Rutkowski, MD, PhD, Samuel J. Ford, FRCS, PhD, Ricardo J. Gonzalez, MD, Rebecca A. Gladdy, MD, PhD, David E. Gyorki, MBBS, MD, Mark Fairweather, MD, Kyo Won Lee, MD, Markus Albertsmeier, MD, Winan J. van Houdt, MD, PhD, Magalie Fau, MD, Carolyn Nessim, MD, MSc, Giovanni Grignani, MD, Kenneth Cardona, MD, Vittorio Quagliuolo, MD, Valerie Grignol, MD, Jeffrey M. Farma, MD, Elisabetta Pennacchioli, MD, Marco Fiore, MD, Andrew Hayes, MA, PhD, Dimitri Tzanis, MD, PhD, Jacek Skoczylas, MD, Max L. Almond, DM, John E. Mullinax, MD, Wendy Johnston, PhD, Hayden Snow, MBBS, Rick L. Haas, MD, PhD, Dario Callegaro, MD, Myles J. Smith, MB, BCh, BAO, PhD, Toufik Bouhadiba, MD, Anant Desai, MA, MD, Rachel Voss, MD, MPH, Roberta Sanfilippo, MD, Robin L. Jones, BSc, MBBS, MD (Res), Elizabeth H. Baldini, MD,MPH, Andrew J. Wagner, MD, PhD, Charles N. Catton, MD, Silvia Stacchiotti, MD, Khin Thway, MD, FRCPath, Christina L. Roland, MD, MS, Chandrajit P. Raut, MD, MSc, Alessandro Gronchi, MD, the Transatlantic Australasian Retroperitoneal Sarcoma Working Group
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 12/2022
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Abstract
Background
Surgery is the mainstay of treatment for retroperitoneal sarcoma (RPS), but local recurrence is common. Biologic behavior and recurrence patterns differ significantly among histologic types of RPS, with implications for management. The Transatlantic Australasian RPS Working Group (TARPSWG) published a consensus approach to primary RPS, and to complement this, one for recurrent RPS in 2016. Since then, additional studies have been published, and collaborative discussion is ongoing to address the clinical challenges of local recurrence in RPS.
Methods
An extensive literature search was performed, and the previous consensus statements for recurrent RPS were updated after review by TARPSWG members. The search included the most common RPS histologic types: liposarcoma, leiomyosarcoma, solitary fibrous tumor, undifferentiated pleomorphic sarcoma, and malignant peripheral nerve sheath tumor.
Results
Recurrent RPS management was evaluated from diagnosis to follow-up evaluation. For appropriately selected patients, resection is safe. Nomograms currently are available to help predict outcome after resection. These and other new findings have been combined with expert recommendations to provide 36 statements, each of which is attributed a level of evidence and grade of recommendation. In this updated document, more emphasis is placed on histologic type and clarification of the intent for surgical treatment, either curative or palliative. Overall, the fundamental tenet of optimal care for patients with recurrent RPS remains individualized treatment after multidisciplinary discussion by an experienced team with expertise in RPS.
Conclusions
Updated consensus recommendations are provided to help guide decision-making for treatment of locally recurrent RPS and better selection of patients who would potentially benefit from surgery.