Abstract
Soft-tissue sarcomas (STS) are a heterogeneous group of neoplasms which may be subclassified into over 70 specific histologies and may be distributed throughout the body. Approximately one-half arises in the extremities and one-third arises in the abdomen, pelvis, and retroperitoneum. The diversity and rarity of sarcomas combined with the quite large number of affected patients are factors which underline of the importance of networking in diagnosis, therapy, and research dealing with rare cancers. The expertise of the treating center is one of the most significant factors affecting survival in STS. The optimal treatment of locally recurrent disease is to prevent it; aggressive multidisciplinary treatment of the primary disease is thus required, as adjuvant therapies cannot compensate for inadequate surgery. Treatment within specialized multidisciplinary teams (MDTs) is crucial; a body of expertise in all the areas of diagnosis and treatment is required to manage STS appropriately. Conformity to approved treatment guidelines is improved when patients are treated by an MDT in a reference centre. Traditionally, peer-reviewed literature has discussed the surgical management of STS based on the site of origin. While the site of origin remains an important consideration, it has become increasingly clear that surgery must also be tailored to specific sarcoma histology to more accurately reflect tumor biology and pattern of recurrence. All sarcoma operations, included retroperitoneal surgery, should be performed in specialized centres to ensure optimal outcomes.
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References
Stiller CA, Trama A, Serraino D et al (2013) RARECARE Working Group. Descriptive epidemiology of sarcomas in Europe: report from the RARECARE project. Eur J Cancer 49(3):684–695
Judson I (2013) Role of expert centres in the management of sarcomas open access, review article. Eur J Cancer Suppl 11(2):310–311
Koulaxouzidis G, Schwarzkopf E, Bannasch H et al (2015) Is revisional surgery mandatory when an unexpected sarcoma diagnosis is made following primary surgery? World J Surg Oncol 13:306–316
Gutierrez JC, Perez EA, Franceschi D et al (2007) Outcomes for soft-tissue sarcoma in 8249 cases from a large state cancer registry. J Surg Res 141:105–114
Randall RL, Bruckner JD, Papenhausen MD et al (2004) Errors in diagnosis and margin determination of soft-tissue sarcomas initially treated at non-tertiary centers. Orthopedics 27(2):209–212
Gutierrez JC, Perez EA, Moffat FL et al (2007) Should soft tissue sarcomas be treated at high-volume centers? An analysis of 4205 patients. Ann Surg 245(6):952–958
Eilber FR, Eckardt J (1997) Surgical management of soft tissue sarcomas. Semin Oncol 24(5):526–533
Ray-Coquard I, Thiesse P, Ranchere-Vince D et al (2004) Conformity to clinical practice guidelines, multidisciplinary management and outcome of treatment for soft tissue sarcomas. Ann Oncol 15:307–315
Bhangu AA, Beard JA, Grimer RJ (2004) Should soft tissue sarcomas be treated at a specialist centre? Sarcoma 8:1–6
Stoeckle E, Italiano A, Stock N et al (2008) Surgical margins in soft tissue sarcoma. Bull Cancer 95(12):1199–1204
Gronchi A, Miceli R, Allard MA et al (2015) Personalizing the approach to retroperitoneal soft tissue sarcoma: histology-specific patterns of failure and postrelapse outcome after primary extended resection. Ann Surg Oncol 22:1447–1454
Raut CP, Gronchi A (2014) The management of soft tissue sarcoma. In: Cameron JL, Cameron AM (eds) Current Surgical Therapy. Elsevier Saunders, Philadelphia, pp 706–717
Gronchi A, Dei Tos AP, Casali PG (2016) Sarcomas of Soft Tissue and Bone. In: Kerr DJ, Haller DG, van de Velde CJH, Baumann M (eds.) Oxford Textbook of Oncology, Oxford University, Oxford, p 844–866
Rare Cancers Network Europe (2016) http://www.rarecarenet.eu/rarecarenet/. Accessed March 2016
ESMO/European Sarcoma Network Working Group (2012) Soft tissue and visceral sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 23(Suppl 7):92–99 (vii)
NICE guidelines (2016) http://guidance.nice.org.uk/CSG). Accessed March 2016
The Sarcoma Alliance (2016) http://sarcomaalliance.org/sarcoma-centers. Accessed March 2016
Qureshi YA, Huddy JR, Miller JD et al (2012) Unplanned excision of soft tissue sarcoma results in increased rates of local recurrence despite full further oncological treatment. Ann Surg Oncol 19:871–877
Bonvalot S, Raut CP, Pollock RE et al (2012) Technical considerations in surgery for retroperitoneal sarcomas: position paper from E-Surge, a master class in sarcoma surgery, and EORTC-STBSG. Ann Surg Oncol 19:2981–2991
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Sandrucci, S., Trama, A., Quagliuolo, V. et al. Accreditation for centers of sarcoma surgery. Updates Surg 69, 1–7 (2017). https://doi.org/10.1007/s13304-016-0382-z
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DOI: https://doi.org/10.1007/s13304-016-0382-z