Brazilian consensus on the diagnosis and treatment of extremities soft tissue sarcomas

Introduction Soft tissue sarcomas (STSs) are rare tumors and constitute only 1% of all tumors in adults. Indeed, due to their rarity, most cases in Brazil are not treated according to primary international guidelines. Methods This consensus addresses the treatment of STSs in the extremities. It was...

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Veröffentlicht in:Journal of surgical oncology 2020-04, Vol.121 (5), p.743-758
Hauptverfasser: Spencer, Ranyell M. S. S. B., Camargo, Veridiana P., Silva, Maria L. G., Pinto, Fabio F. E., Costa, Felipe D'Almeida, Cequeira, Wagner S., Munhoz, Rodrigo R., Mello, Celso A., Schmerling, Rafael A., Filho, Waldec J. D., Coelho, Tharcisio M., Ambrosio, Alexandre V. A., Leite, Elton T. T., Hanna, Samir A., Nakagawa, Sueli A., Baptista, Andre M., Pinheiro, Rodrigo N., Oliveira, Jadivan L., Araújo, Marcelo Sá, Araujo, Raphael L. C., Laporte, Gustavo A., Almeida Quadros, Claudio, Oliveira, Alexandre F., Lopes, Ademar
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container_end_page 758
container_issue 5
container_start_page 743
container_title Journal of surgical oncology
container_volume 121
creator Spencer, Ranyell M. S. S. B.
Camargo, Veridiana P.
Silva, Maria L. G.
Pinto, Fabio F. E.
Costa, Felipe D'Almeida
Cequeira, Wagner S.
Munhoz, Rodrigo R.
Mello, Celso A.
Schmerling, Rafael A.
Filho, Waldec J. D.
Coelho, Tharcisio M.
Ambrosio, Alexandre V. A.
Leite, Elton T. T.
Hanna, Samir A.
Nakagawa, Sueli A.
Baptista, Andre M.
Pinheiro, Rodrigo N.
Oliveira, Jadivan L.
Araújo, Marcelo Sá
Araujo, Raphael L. C.
Laporte, Gustavo A.
Almeida Quadros, Claudio
Oliveira, Alexandre F.
Lopes, Ademar
description Introduction Soft tissue sarcomas (STSs) are rare tumors and constitute only 1% of all tumors in adults. Indeed, due to their rarity, most cases in Brazil are not treated according to primary international guidelines. Methods This consensus addresses the treatment of STSs in the extremities. It was made by workgroups from Brazilian Societies of Surgical Oncology, Orthopaedics, Clinical Oncology, Pathology, Radiology and Diagnostic Imaging, and Radiation Oncology. The workgroups based their arguments on the best level of evidence in the literature and recommendations were made according to diagnosis, staging, and treatment of STSs. A meeting was held with all the invited experts and the topics were presented individually with the definition of the degree of recommendation, based on the levels of evidence in the literature. Results Risk factors and epidemiology were described as well as the pathological aspects and imaging. All recommendations are described with the degree of recommendation and levels of evidence. Conclusion Recommendations based on the best literature regional aspects were made to guide professionals who treat STS. Separate consensus on specific treatments for retroperitoneal, visceral, trunk, head and neck sarcomas, and gastrointestinal stromal tumor, are not contemplated into this consensus.
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S. S. B. ; Camargo, Veridiana P. ; Silva, Maria L. G. ; Pinto, Fabio F. E. ; Costa, Felipe D'Almeida ; Cequeira, Wagner S. ; Munhoz, Rodrigo R. ; Mello, Celso A. ; Schmerling, Rafael A. ; Filho, Waldec J. D. ; Coelho, Tharcisio M. ; Ambrosio, Alexandre V. A. ; Leite, Elton T. T. ; Hanna, Samir A. ; Nakagawa, Sueli A. ; Baptista, Andre M. ; Pinheiro, Rodrigo N. ; Oliveira, Jadivan L. ; Araújo, Marcelo Sá ; Araujo, Raphael L. C. ; Laporte, Gustavo A. ; Almeida Quadros, Claudio ; Oliveira, Alexandre F. ; Lopes, Ademar</creator><creatorcontrib>Spencer, Ranyell M. S. S. B. ; Camargo, Veridiana P. ; Silva, Maria L. G. ; Pinto, Fabio F. E. ; Costa, Felipe D'Almeida ; Cequeira, Wagner S. ; Munhoz, Rodrigo R. ; Mello, Celso A. ; Schmerling, Rafael A. ; Filho, Waldec J. D. ; Coelho, Tharcisio M. ; Ambrosio, Alexandre V. A. ; Leite, Elton T. T. ; Hanna, Samir A. ; Nakagawa, Sueli A. ; Baptista, Andre M. ; Pinheiro, Rodrigo N. ; Oliveira, Jadivan L. ; Araújo, Marcelo Sá ; Araujo, Raphael L. C. ; Laporte, Gustavo A. ; Almeida Quadros, Claudio ; Oliveira, Alexandre F. ; Lopes, Ademar</creatorcontrib><description>Introduction Soft tissue sarcomas (STSs) are rare tumors and constitute only 1% of all tumors in adults. Indeed, due to their rarity, most cases in Brazil are not treated according to primary international guidelines. Methods This consensus addresses the treatment of STSs in the extremities. It was made by workgroups from Brazilian Societies of Surgical Oncology, Orthopaedics, Clinical Oncology, Pathology, Radiology and Diagnostic Imaging, and Radiation Oncology. The workgroups based their arguments on the best level of evidence in the literature and recommendations were made according to diagnosis, staging, and treatment of STSs. A meeting was held with all the invited experts and the topics were presented individually with the definition of the degree of recommendation, based on the levels of evidence in the literature. Results Risk factors and epidemiology were described as well as the pathological aspects and imaging. All recommendations are described with the degree of recommendation and levels of evidence. Conclusion Recommendations based on the best literature regional aspects were made to guide professionals who treat STS. Separate consensus on specific treatments for retroperitoneal, visceral, trunk, head and neck sarcomas, and gastrointestinal stromal tumor, are not contemplated into this consensus.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.25847</identifier><identifier>PMID: 31970785</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Biopsy ; Brazil ; Cancer therapies ; Chemotherapy, Adjuvant ; Extremities - pathology ; Extremities - surgery ; Gastrointestinal cancer ; Humans ; Lymph Nodes - pathology ; multidisciplinary sarcoma ; Neoplasm Metastasis - diagnosis ; Neoplasm Metastasis - therapy ; Neoplasm Staging ; Oncology ; Palliative Care ; Postoperative Complications - therapy ; Radiotherapy, Adjuvant ; Risk Factors ; Sarcoma ; Sarcoma - diagnostic imaging ; Sarcoma - pathology ; Sarcoma - therapy ; sarcoma consensus ; sarcoma reference cancer centers ; Soft Tissue Neoplasms - diagnostic imaging ; Soft Tissue Neoplasms - pathology ; Soft Tissue Neoplasms - therapy ; soft tissue sarcomas ; Tumors</subject><ispartof>Journal of surgical oncology, 2020-04, Vol.121 (5), p.743-758</ispartof><rights>2020 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3537-b04cc89280cd224e10a1b66bc0d47ae98b50c24de16c3c2d02a266d433e71ca73</citedby><cites>FETCH-LOGICAL-c3537-b04cc89280cd224e10a1b66bc0d47ae98b50c24de16c3c2d02a266d433e71ca73</cites><orcidid>0000-0002-7834-5944 ; 0000-0002-1976-0662 ; 0000-0002-4497-5964</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjso.25847$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.25847$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>309,310,314,777,781,786,787,1412,23911,23912,25121,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31970785$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spencer, Ranyell M. S. S. B.</creatorcontrib><creatorcontrib>Camargo, Veridiana P.</creatorcontrib><creatorcontrib>Silva, Maria L. G.</creatorcontrib><creatorcontrib>Pinto, Fabio F. E.</creatorcontrib><creatorcontrib>Costa, Felipe D'Almeida</creatorcontrib><creatorcontrib>Cequeira, Wagner S.</creatorcontrib><creatorcontrib>Munhoz, Rodrigo R.</creatorcontrib><creatorcontrib>Mello, Celso A.</creatorcontrib><creatorcontrib>Schmerling, Rafael A.</creatorcontrib><creatorcontrib>Filho, Waldec J. D.</creatorcontrib><creatorcontrib>Coelho, Tharcisio M.</creatorcontrib><creatorcontrib>Ambrosio, Alexandre V. A.</creatorcontrib><creatorcontrib>Leite, Elton T. T.</creatorcontrib><creatorcontrib>Hanna, Samir A.</creatorcontrib><creatorcontrib>Nakagawa, Sueli A.</creatorcontrib><creatorcontrib>Baptista, Andre M.</creatorcontrib><creatorcontrib>Pinheiro, Rodrigo N.</creatorcontrib><creatorcontrib>Oliveira, Jadivan L.</creatorcontrib><creatorcontrib>Araújo, Marcelo Sá</creatorcontrib><creatorcontrib>Araujo, Raphael L. C.</creatorcontrib><creatorcontrib>Laporte, Gustavo A.</creatorcontrib><creatorcontrib>Almeida Quadros, Claudio</creatorcontrib><creatorcontrib>Oliveira, Alexandre F.</creatorcontrib><creatorcontrib>Lopes, Ademar</creatorcontrib><title>Brazilian consensus on the diagnosis and treatment of extremities soft tissue sarcomas</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Introduction Soft tissue sarcomas (STSs) are rare tumors and constitute only 1% of all tumors in adults. Indeed, due to their rarity, most cases in Brazil are not treated according to primary international guidelines. Methods This consensus addresses the treatment of STSs in the extremities. It was made by workgroups from Brazilian Societies of Surgical Oncology, Orthopaedics, Clinical Oncology, Pathology, Radiology and Diagnostic Imaging, and Radiation Oncology. The workgroups based their arguments on the best level of evidence in the literature and recommendations were made according to diagnosis, staging, and treatment of STSs. A meeting was held with all the invited experts and the topics were presented individually with the definition of the degree of recommendation, based on the levels of evidence in the literature. Results Risk factors and epidemiology were described as well as the pathological aspects and imaging. All recommendations are described with the degree of recommendation and levels of evidence. Conclusion Recommendations based on the best literature regional aspects were made to guide professionals who treat STS. Separate consensus on specific treatments for retroperitoneal, visceral, trunk, head and neck sarcomas, and gastrointestinal stromal tumor, are not contemplated into this consensus.</description><subject>Biopsy</subject><subject>Brazil</subject><subject>Cancer therapies</subject><subject>Chemotherapy, Adjuvant</subject><subject>Extremities - pathology</subject><subject>Extremities - surgery</subject><subject>Gastrointestinal cancer</subject><subject>Humans</subject><subject>Lymph Nodes - pathology</subject><subject>multidisciplinary sarcoma</subject><subject>Neoplasm Metastasis - diagnosis</subject><subject>Neoplasm Metastasis - therapy</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Palliative Care</subject><subject>Postoperative Complications - therapy</subject><subject>Radiotherapy, Adjuvant</subject><subject>Risk Factors</subject><subject>Sarcoma</subject><subject>Sarcoma - diagnostic imaging</subject><subject>Sarcoma - pathology</subject><subject>Sarcoma - therapy</subject><subject>sarcoma consensus</subject><subject>sarcoma reference cancer centers</subject><subject>Soft Tissue Neoplasms - diagnostic imaging</subject><subject>Soft Tissue Neoplasms - pathology</subject><subject>Soft Tissue Neoplasms - therapy</subject><subject>soft tissue sarcomas</subject><subject>Tumors</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10Mtu1TAQBmALgehpYcELIEts6CLt-BI7XtKKqyp1wWUbOc4c8FFiF08iWp6-hlO6QOpqNJpPv0Y_Yy8EnAgAebqjfCLbTttHbCPAmcaB6x6zTb3JRlsHB-yQaAcAzhn9lB0o4SzYrt2wb2fF_45T9ImHnAgTrcRz4ssP5GP031OmSNynkS8F_TJjWnjecryu6xyXiMQpbxe-RKIVOfkS8uzpGXuy9RPh87t5xL6-e_vl_ENzcfn-4_mbiyaoVtlmAB1C52QHYZRSowAvBmOGAKO2Hl03tBCkHlGYoIIcQXppzKiVQiuCt-qIvd7nXpX8c0Va-jlSwGnyCfNKvVRaS-mEkZW--o_u8lpS_a4qa1wrlVFVHe9VKJmo4La_KnH25aYX0P8pu69l93_LrvblXeI6zDjey3_tVnC6B7_ihDcPJ_WfPl_uI28BoYuJBA</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Spencer, Ranyell M. 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D. ; Coelho, Tharcisio M. ; Ambrosio, Alexandre V. A. ; Leite, Elton T. T. ; Hanna, Samir A. ; Nakagawa, Sueli A. ; Baptista, Andre M. ; Pinheiro, Rodrigo N. ; Oliveira, Jadivan L. ; Araújo, Marcelo Sá ; Araujo, Raphael L. 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C.</creatorcontrib><creatorcontrib>Laporte, Gustavo A.</creatorcontrib><creatorcontrib>Almeida Quadros, Claudio</creatorcontrib><creatorcontrib>Oliveira, Alexandre F.</creatorcontrib><creatorcontrib>Lopes, Ademar</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spencer, Ranyell M. S. S. B.</au><au>Camargo, Veridiana P.</au><au>Silva, Maria L. G.</au><au>Pinto, Fabio F. E.</au><au>Costa, Felipe D'Almeida</au><au>Cequeira, Wagner S.</au><au>Munhoz, Rodrigo R.</au><au>Mello, Celso A.</au><au>Schmerling, Rafael A.</au><au>Filho, Waldec J. D.</au><au>Coelho, Tharcisio M.</au><au>Ambrosio, Alexandre V. A.</au><au>Leite, Elton T. T.</au><au>Hanna, Samir A.</au><au>Nakagawa, Sueli A.</au><au>Baptista, Andre M.</au><au>Pinheiro, Rodrigo N.</au><au>Oliveira, Jadivan L.</au><au>Araújo, Marcelo Sá</au><au>Araujo, Raphael L. C.</au><au>Laporte, Gustavo A.</au><au>Almeida Quadros, Claudio</au><au>Oliveira, Alexandre F.</au><au>Lopes, Ademar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brazilian consensus on the diagnosis and treatment of extremities soft tissue sarcomas</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>121</volume><issue>5</issue><spage>743</spage><epage>758</epage><pages>743-758</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Introduction Soft tissue sarcomas (STSs) are rare tumors and constitute only 1% of all tumors in adults. Indeed, due to their rarity, most cases in Brazil are not treated according to primary international guidelines. Methods This consensus addresses the treatment of STSs in the extremities. It was made by workgroups from Brazilian Societies of Surgical Oncology, Orthopaedics, Clinical Oncology, Pathology, Radiology and Diagnostic Imaging, and Radiation Oncology. The workgroups based their arguments on the best level of evidence in the literature and recommendations were made according to diagnosis, staging, and treatment of STSs. A meeting was held with all the invited experts and the topics were presented individually with the definition of the degree of recommendation, based on the levels of evidence in the literature. Results Risk factors and epidemiology were described as well as the pathological aspects and imaging. All recommendations are described with the degree of recommendation and levels of evidence. Conclusion Recommendations based on the best literature regional aspects were made to guide professionals who treat STS. Separate consensus on specific treatments for retroperitoneal, visceral, trunk, head and neck sarcomas, and gastrointestinal stromal tumor, are not contemplated into this consensus.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31970785</pmid><doi>10.1002/jso.25847</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0002-7834-5944</orcidid><orcidid>https://orcid.org/0000-0002-1976-0662</orcidid><orcidid>https://orcid.org/0000-0002-4497-5964</orcidid></addata></record>
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subjects Biopsy
Brazil
Cancer therapies
Chemotherapy, Adjuvant
Extremities - pathology
Extremities - surgery
Gastrointestinal cancer
Humans
Lymph Nodes - pathology
multidisciplinary sarcoma
Neoplasm Metastasis - diagnosis
Neoplasm Metastasis - therapy
Neoplasm Staging
Oncology
Palliative Care
Postoperative Complications - therapy
Radiotherapy, Adjuvant
Risk Factors
Sarcoma
Sarcoma - diagnostic imaging
Sarcoma - pathology
Sarcoma - therapy
sarcoma consensus
sarcoma reference cancer centers
Soft Tissue Neoplasms - diagnostic imaging
Soft Tissue Neoplasms - pathology
Soft Tissue Neoplasms - therapy
soft tissue sarcomas
Tumors
title Brazilian consensus on the diagnosis and treatment of extremities soft tissue sarcomas
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