A sommelier to guide wine selection and a specialist to manage the sarcoma patient: Barriers to referral and definition of a sarcoma specialist

Tseng, William W.; Gronchi, Alessandro; Bonvalot, Sylvie; Pollock, Raphael E.

doi:10.1002/jso.25863

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…Most importantly, in this study, it is unclear whether these patients were evaluated and managed at sarcoma referral centers, which would include multidisciplinary discussion and evaluation by an experienced sarcoma surgeon, a medical oncologist, and a radiation oncologist. This is critical for optimizing outcomes in RPS and ideal for research purposes, especially in patients with this rare disease 24,25 …”

Section: Discussionmentioning

confidence: 99%

Defining the role of neoadjuvant systemic therapy in high‐risk retroperitoneal sarcoma: A multi‐institutional study from the Transatlantic Australasian Retroperitoneal Sarcoma Working Group

Tseng

Barretta

Conti

et al. 2020

Cancer

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Background In patients with retroperitoneal sarcoma (RPS), the incidence of recurrence after surgery remains high. Novel treatment approaches are needed. This retrospective study evaluated patients with primary, high‐risk RPS who received neoadjuvant systemic therapy followed by surgery to 1) determine the frequency and potential predictors of radiologic tumor responses and 2) assess clinical outcomes. Methods Clinicopathologic data were collected for eligible patients treated at 13 sarcoma referral centers from 2008 to 2018. Univariable and multivariable logistic models were performed to assess the association between clinical predictors and response. Overall survival (OS) and crude cumulative incidences of local recurrence and distant metastasis were compared. Results Data on 158 patients were analyzed. A median of 3 cycles of neoadjuvant systemic therapy (interquartile range, 2‐4 cycles) were given. The regimens were mostly anthracycline based; however, there was significant heterogeneity. No patients demonstrated a complete response, 37 (23%) demonstrated a partial response (PR), 88 (56%) demonstrated stable disease, and 33 (21%) demonstrated progressive disease (PD) according to the Response Evaluation Criteria in Solid Tumors, version 1.1. Only a higher number of cycles given was positively associated with PR (P = .005). All patients underwent complete resection, regardless of the tumor response. Overall, patients whose tumors demonstrated PD before surgery showed markedly worse OS (P = .005). An indication of a better clinical outcome was seen in specific regimens given for grade 3 dedifferentiated liposarcoma and leiomyosarcoma. Conclusions In patients with high‐risk RPS, the response to neoadjuvant systemic therapy is fair overall. Disease progression on therapy may be used to predict survival after surgery. Subtype‐specific regimens should be further validated.

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Section: Discussionmentioning

confidence: 99%

Defining the role of neoadjuvant systemic therapy in high‐risk retroperitoneal sarcoma: A multi‐institutional study from the Transatlantic Australasian Retroperitoneal Sarcoma Working Group

Tseng

Barretta

Conti

et al. 2020

Cancer

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“…For suspected or diagnosed RPS, it is critical for the patient to be initially evaluated and ultimately managed by a surgeon with expertise in this disease. The surgeon is typically a fellowship-trained surgical oncologist with experience and up-to-date knowledge of sarcoma, in some cases even focusing their clinical practice entirely on this disease [10]. The surgical oncologist should be an active, integrated member of a multidisciplinary team of sarcoma specialists that includes medical-and radiation oncologists, as well as pathologists and radiologists.…”

Section: Importance Of Management By a Sarcoma Specialistmentioning

confidence: 99%

“…When RPS patients are seen by specialists, the outcomes are markedly improved [11][12][13][14], which would be intuitive for an ultra-rare, complex malignancy. A volume of 10-13 RPS cases per year has been cited as the minimum threshold for specialist designation [11,13], although this is controversial and should likely include more than just number of cases [10,15].…”

Section: Importance Of Management By a Sarcoma Specialistmentioning

confidence: 99%

Surgical Management of Retroperitoneal Sarcoma

et al. 2023

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Surgery is the cornerstone of treatment for retroperitoneal sarcoma (RPS). Surgery should be performed by a surgical oncologist with sub-specialization in this disease and in the context of a multidisciplinary team of sarcoma specialists. For primary RPS, the goal of surgery is to achieve the complete en bloc resection of the tumor along with involved organs and structures to maximize the clearance of the disease. The extent of resection also needs to consider the risk of complications. Unfortunately, the overarching challenge in primary RPS treatment is that even with optimal surgery, tumor recurrence occurs frequently. The pattern of recurrence after surgery (e.g., local versus distant) is strongly associated with the specific histologic type of RPS. Radiation and systemic therapy may improve outcomes in RPS and there is emerging data studying the benefit of non-surgical treatments in primary disease. Topics in need of further investigation include criteria for unresectability and management of locally recurrent disease. Moving forward, global collaboration among RPS specialists will be key for continuing to advance our understanding of this disease and find more effective treatments.

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Management of Locally Recurrent Retroperitoneal Sarcoma in the Adult: An Updated Consensus Approach from the Transatlantic Australasian Retroperitoneal Sarcoma Working Group

et al. 2022

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A sommelier to guide wine selection and a specialist to manage the sarcoma patient: Barriers to referral and definition of a sarcoma specialist

Cited by 3 publications

References 8 publications

Defining the role of neoadjuvant systemic therapy in high‐risk retroperitoneal sarcoma: A multi‐institutional study from the Transatlantic Australasian Retroperitoneal Sarcoma Working Group

Defining the role of neoadjuvant systemic therapy in high‐risk retroperitoneal sarcoma: A multi‐institutional study from the Transatlantic Australasian Retroperitoneal Sarcoma Working Group

Surgical Management of Retroperitoneal Sarcoma

Management of Locally Recurrent Retroperitoneal Sarcoma in the Adult: An Updated Consensus Approach from the Transatlantic Australasian Retroperitoneal Sarcoma Working Group

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