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Establishment of a Primary Culture of Patient-derived Soft Tissue Sarcoma
Published on: April 11, 2018
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Global Variations in Patterns of Care for Retroperitoneal Sarcoma
Hayden Snow1, Marco Fiore2, Jing Xie1
1Division of Cancer Surgery, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
Annals of Surgery
|June 16, 2025
Summary
Patterns of care for retroperitoneal sarcoma (RPS) vary significantly worldwide, particularly in surgical strategies like comprehensive resection (CR) for liposarcoma and the use of chemotherapy for leiomyosarcoma. Radiotherapy use decreased after the STRASS trial.
Area of Science:
- Oncology
- Surgical Oncology
- Sarcoma Research
Background:
- Retroperitoneal sarcoma (RPS) treatment presents challenges due to its rarity and complexity.
- Global variations in diagnostic and therapeutic approaches for RPS are not well-characterized.
Purpose of the Study:
- To investigate international variations in the management of primary retroperitoneal sarcoma (RPS).
- To analyze differences in diagnostic work-up, surgical strategies (including comprehensive resection), and neoadjuvant/adjuvant therapies across global sarcoma centers.
Main Methods:
- Retrospective analysis of 1718 primary RPS cases from 19 international referral centers.
- Data collected prospectively from Feb 2017 - July 2022 within the RESAR repository (NCT03838718).
- Centers categorized as high-volume (HVC) or low-volume (LVC); comprehensive resection (CR) defined as en-bloc resection of ipsilateral kidney and colon.
Main Results:
- Preoperative biopsy was common (98%) for non-liposarcoma RPS.
- Significant variation in CR for liposarcoma (IQR 37%), especially in LVC (IQR 39.5%) vs. HVC (IQR 9.5%).
- Chemotherapy use was low for liposarcoma (0%) but varied for leiomyosarcoma (10%, IQR 26%); radiotherapy use was low overall but higher in HVC (18.5%) vs. LVC (5%), decreasing post-STRASS trial.
Conclusions:
- Agreement exists on biopsy for non-liposarcomas, chemotherapy for liposarcoma, and radiotherapy for leiomyosarcoma.
- Equipoise suggested for chemotherapy in leiomyosarcoma and the value of CR in liposarcoma.
- Reduced radiotherapy use post-STRASS trial indicates acceptance of its findings.
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