Management of Recurrent Retroperitoneal Sarcoma (RPS) in the Adult

A Consensus Approach from the Trans-Atlantic RPS Working Group

Trans-Atlantic RPS Working Group

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Introduction: Retroperitoneal soft tissue sarcomas (RPS) are rare tumors. Surgery is the mainstay of curative therapy, but local recurrence is common. No recommendations concerning the best management of recurring disease have been developed so far. Although every effort should be made to optimize the initial approach, recommendations to treat recurring RPS will be helpful to maximize disease control at recurrence. Methods: An RPS transatlantic working group was established in 2013. The goals of the group were to share institutional experiences, build large multi-institutional case series, and develop consensus documents on the approach to this difficult disease. The outcome of this document applies to recurrent RPS that is nonvisceral in origin. Included are sarcomas of major veins, undifferentiated pleomorphic sarcoma of psoas, ureteric leiomyosarcoma (LMS). Excluded are desmoids-type fibromatosis, angiomyolipoma, gastrointestinal stromal tumors, sarcomas arising from the gut or its mesentery, uterine LMS, prostatic sarcoma, paratesticular/spermatic cord sarcoma, Ewing sarcoma, alveolar/embryonal rhabdomyosarcoma, sarcoma arising from teratoma, carcinosarcoma, sarcomatoid carcinoma, clear cell sarcoma, radiation-induced sarcoma, paraganglioma, and malignant pheochromocytoma. Results: Recurrent RPS management was evaluated from diagnosis to follow-up. It is a rare and complex malignancy that 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, but some patients may experience prolonged disease control also at recurrence, when the approach is optimized and follows the recommendations contained herein. Conclusions: International collaboration is critical for adding to the present knowledge. A transatlantic prospective registry has been established.

Original languageEnglish (US)
Pages (from-to)3531-3540
Number of pages10
JournalAnnals of Surgical Oncology
Volume23
Issue number11
DOIs
StatePublished - Oct 1 2016

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Sarcoma
Gastrointestinal Stromal Tumors
Leiomyosarcoma
Recurrence
Clear Cell Sarcoma
Alveolar Rhabdomyosarcoma
Embryonal Rhabdomyosarcoma
Spermatic Cord
Aggressive Fibromatosis
Carcinosarcoma
Angiomyolipoma
Paraganglioma
Ewing's Sarcoma
Mesentery
Fibroma
Teratoma
Pheochromocytoma
Disease Management
Registries
Veins

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Management of Recurrent Retroperitoneal Sarcoma (RPS) in the Adult : A Consensus Approach from the Trans-Atlantic RPS Working Group. / Trans-Atlantic RPS Working Group.

In: Annals of Surgical Oncology, Vol. 23, No. 11, 01.10.2016, p. 3531-3540.

Research output: Contribution to journalArticle

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abstract = "Introduction: Retroperitoneal soft tissue sarcomas (RPS) are rare tumors. Surgery is the mainstay of curative therapy, but local recurrence is common. No recommendations concerning the best management of recurring disease have been developed so far. Although every effort should be made to optimize the initial approach, recommendations to treat recurring RPS will be helpful to maximize disease control at recurrence. Methods: An RPS transatlantic working group was established in 2013. The goals of the group were to share institutional experiences, build large multi-institutional case series, and develop consensus documents on the approach to this difficult disease. The outcome of this document applies to recurrent RPS that is nonvisceral in origin. Included are sarcomas of major veins, undifferentiated pleomorphic sarcoma of psoas, ureteric leiomyosarcoma (LMS). Excluded are desmoids-type fibromatosis, angiomyolipoma, gastrointestinal stromal tumors, sarcomas arising from the gut or its mesentery, uterine LMS, prostatic sarcoma, paratesticular/spermatic cord sarcoma, Ewing sarcoma, alveolar/embryonal rhabdomyosarcoma, sarcoma arising from teratoma, carcinosarcoma, sarcomatoid carcinoma, clear cell sarcoma, radiation-induced sarcoma, paraganglioma, and malignant pheochromocytoma. Results: Recurrent RPS management was evaluated from diagnosis to follow-up. It is a rare and complex malignancy that 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, but some patients may experience prolonged disease control also at recurrence, when the approach is optimized and follows the recommendations contained herein. Conclusions: International collaboration is critical for adding to the present knowledge. A transatlantic prospective registry has been established.",
author = "{Trans-Atlantic RPS Working Group} and Jan Ahlen and Nita Ahuja and Robert Antbacka and Sanjay Bagaria and Blay, {Jean Yves} and Sylvie Bonvalot and Dario Callegaro and Canter, {Robert J.} and Kenneth Cardona and Casali, {Paolo G.} and Chiara Colombo and {Dei Tos}, {Angelo P.} and {De Paoli}, Antonino and Anant Desai and Dickson, {Brendan C.} and Eilber, {Fritz C.} and Marco Fiore and Fletcher, {Cristopher D.} and Ford, {Samuel J.} and Gelderblom, {Hans J.} and Ricardo Gonzalez and Giovanni Grignani and Valerie Grignol and Alessandro Gronchi and Haas, {Rick L.} and Hayes, {Andrew J.} and Wolfgang Hartmann and Thomas Henzler and Peter Hohenberger and Antoine Italiano and Jens Jakob and Jones, {Robin L.} and Ian Judson and Kane, {John M.} and Guy Lahat and MacNeill, {Andrea J.} and Roberta Maestro and Christina Messiou and Pierre Meeus and Rosalba Miceli and Mullen, {John T.} and Carolyn Nessim and Elisabetta Pennacchioli and Pillarisetty, {Vinu G.} and Pollock, {Raphael E.} and Vittorio Quagliuolo and Stefano Radaelli and Raut, {Chandrajit P.} and Piotr Rutkowski and Nabil Wasif",
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T1 - Management of Recurrent Retroperitoneal Sarcoma (RPS) in the Adult

T2 - A Consensus Approach from the Trans-Atlantic RPS Working Group

AU - Trans-Atlantic RPS Working Group

AU - Ahlen, Jan

AU - Ahuja, Nita

AU - Antbacka, Robert

AU - Bagaria, Sanjay

AU - Blay, Jean Yves

AU - Bonvalot, Sylvie

AU - Callegaro, Dario

AU - Canter, Robert J.

AU - Cardona, Kenneth

AU - Casali, Paolo G.

AU - Colombo, Chiara

AU - Dei Tos, Angelo P.

AU - De Paoli, Antonino

AU - Desai, Anant

AU - Dickson, Brendan C.

AU - Eilber, Fritz C.

AU - Fiore, Marco

AU - Fletcher, Cristopher D.

AU - Ford, Samuel J.

AU - Gelderblom, Hans J.

AU - Gonzalez, Ricardo

AU - Grignani, Giovanni

AU - Grignol, Valerie

AU - Gronchi, Alessandro

AU - Haas, Rick L.

AU - Hayes, Andrew J.

AU - Hartmann, Wolfgang

AU - Henzler, Thomas

AU - Hohenberger, Peter

AU - Italiano, Antoine

AU - Jakob, Jens

AU - Jones, Robin L.

AU - Judson, Ian

AU - Kane, John M.

AU - Lahat, Guy

AU - MacNeill, Andrea J.

AU - Maestro, Roberta

AU - Messiou, Christina

AU - Meeus, Pierre

AU - Miceli, Rosalba

AU - Mullen, John T.

AU - Nessim, Carolyn

AU - Pennacchioli, Elisabetta

AU - Pillarisetty, Vinu G.

AU - Pollock, Raphael E.

AU - Quagliuolo, Vittorio

AU - Radaelli, Stefano

AU - Raut, Chandrajit P.

AU - Rutkowski, Piotr

AU - Wasif, Nabil

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Introduction: Retroperitoneal soft tissue sarcomas (RPS) are rare tumors. Surgery is the mainstay of curative therapy, but local recurrence is common. No recommendations concerning the best management of recurring disease have been developed so far. Although every effort should be made to optimize the initial approach, recommendations to treat recurring RPS will be helpful to maximize disease control at recurrence. Methods: An RPS transatlantic working group was established in 2013. The goals of the group were to share institutional experiences, build large multi-institutional case series, and develop consensus documents on the approach to this difficult disease. The outcome of this document applies to recurrent RPS that is nonvisceral in origin. Included are sarcomas of major veins, undifferentiated pleomorphic sarcoma of psoas, ureteric leiomyosarcoma (LMS). Excluded are desmoids-type fibromatosis, angiomyolipoma, gastrointestinal stromal tumors, sarcomas arising from the gut or its mesentery, uterine LMS, prostatic sarcoma, paratesticular/spermatic cord sarcoma, Ewing sarcoma, alveolar/embryonal rhabdomyosarcoma, sarcoma arising from teratoma, carcinosarcoma, sarcomatoid carcinoma, clear cell sarcoma, radiation-induced sarcoma, paraganglioma, and malignant pheochromocytoma. Results: Recurrent RPS management was evaluated from diagnosis to follow-up. It is a rare and complex malignancy that 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, but some patients may experience prolonged disease control also at recurrence, when the approach is optimized and follows the recommendations contained herein. Conclusions: International collaboration is critical for adding to the present knowledge. A transatlantic prospective registry has been established.

AB - Introduction: Retroperitoneal soft tissue sarcomas (RPS) are rare tumors. Surgery is the mainstay of curative therapy, but local recurrence is common. No recommendations concerning the best management of recurring disease have been developed so far. Although every effort should be made to optimize the initial approach, recommendations to treat recurring RPS will be helpful to maximize disease control at recurrence. Methods: An RPS transatlantic working group was established in 2013. The goals of the group were to share institutional experiences, build large multi-institutional case series, and develop consensus documents on the approach to this difficult disease. The outcome of this document applies to recurrent RPS that is nonvisceral in origin. Included are sarcomas of major veins, undifferentiated pleomorphic sarcoma of psoas, ureteric leiomyosarcoma (LMS). Excluded are desmoids-type fibromatosis, angiomyolipoma, gastrointestinal stromal tumors, sarcomas arising from the gut or its mesentery, uterine LMS, prostatic sarcoma, paratesticular/spermatic cord sarcoma, Ewing sarcoma, alveolar/embryonal rhabdomyosarcoma, sarcoma arising from teratoma, carcinosarcoma, sarcomatoid carcinoma, clear cell sarcoma, radiation-induced sarcoma, paraganglioma, and malignant pheochromocytoma. Results: Recurrent RPS management was evaluated from diagnosis to follow-up. It is a rare and complex malignancy that 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, but some patients may experience prolonged disease control also at recurrence, when the approach is optimized and follows the recommendations contained herein. Conclusions: International collaboration is critical for adding to the present knowledge. A transatlantic prospective registry has been established.

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