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Article ; Online: Surgery in soft tissue sarcoma: the thin line between a surgical or more conservative approach.

Gronchi, Alessandro

2021 Volume 17, Issue 21s, Page(s) 3–6

Abstract: Surgery is the primary treatment for localized, clinically resectable soft tissue sarcoma (STS). Chemotherapy and radiotherapy, administered in the pre- or post-operative settings, have important ancillary roles in the multimodal management of primary ... ...

Abstract	Surgery is the primary treatment for localized, clinically resectable soft tissue sarcoma (STS). Chemotherapy and radiotherapy, administered in the pre- or post-operative settings, have important ancillary roles in the multimodal management of primary STS. Some sarcoma centers also employ locoregional therapies such as isolated limb perfusion and deep wave hyperthermia in multimodal therapy. In advanced or metastatic STS, surgery is recommended when complete resection is feasible. Nevertheless, in certain situations there is thin line between a surgical or non-surgical approach, generally related to STS histological type/subtype, disease stage and technical considerations. In advanced STS, factors favoring surgery are isolated oligometastatic disease, long disease-free interval, suitable histology, response to chemotherapy and high probability of a complete resection.
MeSH term(s)	Clinical Decision-Making ; Conservative Treatment/standards ; Disease-Free Survival ; Humans ; Medical Oncology/standards ; Neoplasm Staging ; Patient Selection ; Practice Guidelines as Topic ; Sarcoma/diagnosis ; Sarcoma/mortality ; Sarcoma/pathology ; Sarcoma/therapy ; Surgical Procedures, Operative/standards
Language	English
Publishing date	2021-06-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2274956-1
ISSN	1744-8301 ; 1479-6694
ISSN (online)	1744-8301
ISSN	1479-6694
DOI	10.2217/fon-2021-0449
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Zs.A 6478: Show issues

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Article ; Online: Extremity and Truncal Soft Tissue Sarcoma: Risk Assessment and Multidisciplinary Management.

Borghi, Alessandra / Gronchi, Alessandro

Seminars in radiation oncology

2024 Volume 34, Issue 2, Page(s) 147–163

Abstract: Extremity and truncal soft tissue sarcomas are a heterogeneous group of rare cancers that arise from mesenchymal tissues. Hence, the adoption of tailored risk assessment and prognostication tools plays a crucial role in optimizing the decision-making for ...

Abstract	Extremity and truncal soft tissue sarcomas are a heterogeneous group of rare cancers that arise from mesenchymal tissues. Hence, the adoption of tailored risk assessment and prognostication tools plays a crucial role in optimizing the decision-making for which of the many possible treatment strategies to select. Management of these tumors requires a multidisciplinary strategy, which has seen significant development in recent decades. Surgery has emerged as the primary treatment approach, with the main goal of achieving microscopic negative tumor margins. To reduce the likelihood of local recurrence, loco-regional treatments such as radiation therapy and isolated limb perfusion are often added to the treatment regimen in combination with surgery. This approach also enables surgeons to perform limb-sparing surgery, particularly in cases where a positive tumor margin is expected. Chemotherapy may also provide a further benefit in decreasing the probability of local recurrence or reducing distant metastasis in selected patients. Selecting the optimal treatment strategy for these rare tumors is best accomplished by an experienced multi-disciplinary team.
MeSH term(s)	Humans ; Risk Assessment ; Combined Modality Therapy ; Extremities/pathology ; Extremities/surgery ; Sarcoma/pathology ; Sarcoma/surgery ; Radiotherapy, Adjuvant ; Soft Tissue Neoplasms/pathology ; Soft Tissue Neoplasms/radiotherapy ; Neoplasm Recurrence, Local/prevention & control ; Neoplasm Recurrence, Local/pathology
Language	English
Publishing date	2024-03-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1146999-7
ISSN	1532-9461 ; 1053-4296
ISSN (online)	1532-9461
ISSN	1053-4296
DOI	10.1016/j.semradonc.2023.12.001
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Zs.A 3654: Show issues

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Article ; Online: Corrigenda.

Borghi, Alessandra / Gronchi, Alessandro

The bone & joint journal

2023 Volume 105-B, Issue 9, Page(s) 1030

Language	English
Publishing date	2023-09-01
Publishing country	England
Document type	Journal Article ; Published Erratum
ZDB-ID	2697156-2
ISSN	2049-4408 ; 2049-4394
ISSN (online)	2049-4408
ISSN	2049-4394
DOI	10.1302/0301-620X.105B9.BJJ-2023-00034
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Zs.A 6989: Show issues

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Article ; Online: Staging Systems and Nomograms for Soft Tissue Sarcoma.

Danieli, Maria / Gronchi, Alessandro

Current oncology (Toronto, Ont.)

2023 Volume 30, Issue 4, Page(s) 3648–3671

Abstract: Reliable tools for prognosis prediction are crucially needed by oncologists so they can tailor individual treatments. However, the wide spectrum of histologies and prognostic behaviors of sarcomas challenges their development. In this field, nomograms ... ...

Abstract	Reliable tools for prognosis prediction are crucially needed by oncologists so they can tailor individual treatments. However, the wide spectrum of histologies and prognostic behaviors of sarcomas challenges their development. In this field, nomograms could definitely better account for their granularity compared to the more widely used AJCC/UICC TNM staging system. Nomograms are predictive tools that incorporate multiple risk factors and return a numerical probability of a clinical event. Since the development of the first nomogram in 2002, several other nomograms have been built, either general, site-specific, histology-specific, or both. Recently, some new "dynamic" nomograms and prognostic tools have been developed, allowing doctors to "recalculate" a patient's prognosis by taking into account the time since primary surgery, the event history, and the potential time-dependent effect of covariates. Due to these new tools, prognosis prediction is no longer limited to the time of the first computation but can be adapted and recalculated based on the occurrence (or not) of any event as time passes from the first computation. In this review, we aimed to give an overview of the available nomograms for STS and to help clinicians in the process of selecting the best tool for each patient.
MeSH term(s)	Humans ; Nomograms ; Prognosis ; Neoplasm Staging ; Sarcoma/pathology ; Soft Tissue Neoplasms
Language	English
Publishing date	2023-03-26
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol30040278
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Zs.A 4305: Show issues

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Article ; Online: Next questions in the management of retroperitoneal sarcoma.

Drohan, Ashley / Gronchi, Alessandro

Current opinion in oncology

2023 Volume 35, Issue 4, Page(s) 301–308

Abstract: Purpose of review: Retroperitoneal soft-tissue sarcomas (RPS) are a group of rare, histologically distinct tumours with variable recurrence patterns depending on histological type. This review will discuss the growing body of evidence supporting ... ...

Abstract	Purpose of review: Retroperitoneal soft-tissue sarcomas (RPS) are a group of rare, histologically distinct tumours with variable recurrence patterns depending on histological type. This review will discuss the growing body of evidence supporting histology-specific, multidisciplinary management and highlight areas of future research for patients with RPS. Recent findings: Histology-tailored surgery is the cornerstone of management in patients with localized RPS. Further efforts to develop resectability criteria and identify patients who will benefit from neoadjuvant treatment strategies will help standardize the treatment of patients with localized RPS. Surgery for local recurrence is well tolerated in selected patients and re-iterative surgery in liposarcoma (LPS) may be beneficial at the time of local recurrence. The management of advanced RPS holds promise with several trials currently investigating systemic treatment beyond conventional chemotherapy. Summary: The management of RPS has made significant progress over the past decade owing to international collaboration. Ongoing efforts to identify patients who will derive the most benefit from all treatment strategies will continue to advance the field of RPS.
MeSH term(s)	Humans ; Sarcoma/drug therapy ; Sarcoma/surgery ; Neoadjuvant Therapy ; Retroperitoneal Neoplasms/surgery ; Retroperitoneal Neoplasms/drug therapy ; Soft Tissue Neoplasms ; Neoplasm Recurrence, Local/pathology
Language	English
Publishing date	2023-05-09
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1049384-0
ISSN	1531-703X ; 1040-8746
ISSN (online)	1531-703X
ISSN	1040-8746
DOI	10.1097/CCO.0000000000000954
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Zs.A 3046: Show issues

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Article ; Online: Desmoid tumours (extra-abdominal), a surgeon's nightmare.

Borghi, Alessandra / Gronchi, Alessandro

The bone & joint journal

2023 Volume 105-B, Issue 7, Page(s) 729–734

Abstract: Desmoid tumours are a rare fibroblastic proliferation of monoclonal origin, arising in deep soft-tissues. Histologically, they are characterized by locally aggressive behaviour and an inability to metastasize, and clinically by a heterogeneous and ... ...

Abstract	Desmoid tumours are a rare fibroblastic proliferation of monoclonal origin, arising in deep soft-tissues. Histologically, they are characterized by locally aggressive behaviour and an inability to metastasize, and clinically by a heterogeneous and unpredictable course. Desmoid tumours can occur in any anatomical site, but commonly arise in the limbs. Despite their benign nature, they can be extremely disabling and sometimes life-threatening, causing severe pain and functional limitations. Their surgical management is complex and challenging, due to uncertainties surrounding the biological and clinical behaviour, rarity, and limited available literature. Resection has been the first-line approach for patients with a desmoid tumour but, during the last few decades, a shift towards a more conservative approach has occurred, with an initial 'wait and see' policy. Many medical and regional forms of treatment are also available for the management of this condition, and others have recently emerged with promising results. However, many areas of controversy remain, and further studies and global collaboration are needed to obtain prospective and randomized data, in order to develop an appropriate shared stepwise approach.
MeSH term(s)	Humans ; Extremities ; Fibromatosis, Aggressive/surgery ; Prospective Studies ; Surgeons
Language	English
Publishing date	2023-07-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2697156-2
ISSN	2049-4408 ; 2049-4394
ISSN (online)	2049-4408
ISSN	2049-4394
DOI	10.1302/0301-620X.105B7.BJJ-2023-0117
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Zs.A 6989: Show issues

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Article ; Online: Extraperitoneal lateral pelvic sidewall excision: a novel rectal-sparing approach for lateral locally recurrent rectal cancer.

Sorrentino, Luca / Colletti, Gaia / Belli, Filiberto / Gronchi, Alessandro

Updates in surgery

2024

Abstract: Locally recurrent rectal cancer (LRRC) involving the lateral pelvic sidewall requires a complex approach to maximize the likelihood of R0 resection, which is the only predictor of survival. The purpose of this report is to describe a novel technique to ... ...

Abstract	Locally recurrent rectal cancer (LRRC) involving the lateral pelvic sidewall requires a complex approach to maximize the likelihood of R0 resection, which is the only predictor of survival. The purpose of this report is to describe a novel technique to resect a localized lateral pelvic sidewall LRRC. A 63-year-old male patient was referred for a 15-mm LRRC near the right internal iliac vessels. Endoscopic ultrasound and magnetic resonance imaging excluded any involvement of the pelvic colon or residual rectum. A combined extraperitoneal antero-lateral approach and gluteal access were used to optimize vascular control on the internal iliac vessels, to promptly identify the ureter and to achieve a better posterior exposition of the sciatic notch. This technique allowed a controlled and tailored resection of pelvic sidewall without entering into the abdominal cavity. The postoperative course was uneventful. The pathologic report confirmed clear margins (R0), with one involving obturator lymph node. At 3 months, the patient is alive and free from local re-relapse. A right lung metastasis has occurred, and it was treated by stereotactic radiotherapy. The present report proposes a novel extraperitoneal pelvic sidewall excision to resect lateral LRRC with a colorectal-sparing approach, thus minimizing the risk of exenterative surgery-related complications. A proper selection of patients is mandatory, as the proposed technique could not be generalized as the standard of care in all lateral LRRCs.
Language	English
Publishing date	2024-04-06
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-024-01834-2
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Zs.B 101: Show issues

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Article ; Online: In response to: "Intraoperative radiation therapy (IORT) for soft tissue sarcoma - ESTRO IORT task force/ACROP recommendations".

Haas, R L / Gronchi, A

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2020 Volume 154, Page(s) 170–171

MeSH term(s)	Humans ; Sarcoma/radiotherapy ; Soft Tissue Neoplasms/radiotherapy ; Soft Tissue Neoplasms/surgery
Language	English
Publishing date	2020-09-24
Publishing country	Ireland
Document type	Letter ; Comment
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2020.09.040
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Zs.A 1926: Show issues

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Article ; Online: Towards the standard use of (neo)adjuvant chemotherapy in selected localised soft tissue sarcoma at high risk of relapse: are we finally getting there?

Gronchi, Alessandro

European journal of cancer (Oxford, England : 1990)

2018 Volume 101, Page(s) 251–253

MeSH term(s)	Adult ; Chemotherapy, Adjuvant ; Child ; Humans ; Neoplasm Recurrence, Local ; Risk Factors ; Sarcoma ; Soft Tissue Neoplasms
Language	English
Publishing date	2018-07-13
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	82061-1
ISSN	1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
ISSN (online)	1879-0852
ISSN	0277-5379 ; 0959-8049 ; 0964-1947
DOI	10.1016/j.ejca.2018.06.004
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Zs.A 456: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 583: Show issues

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Article: Neoadjuvant Therapy for Primary Resectable Retroperitoneal Sarcomas-Looking Forward.

Istl, Alexandra C / Gronchi, Alessandro

Cancers

2022 Volume 14, Issue 7

Abstract: The cornerstone of therapy for primary retroperitoneal sarcomas (RPS) is complete surgical resection, best achieved by resecting the tumor en bloc with adherent structures even if not overtly infiltrated. Until recently, trials designed to elucidate the ... ...

Abstract	The cornerstone of therapy for primary retroperitoneal sarcomas (RPS) is complete surgical resection, best achieved by resecting the tumor en bloc with adherent structures even if not overtly infiltrated. Until recently, trials designed to elucidate the role of neoadjuvant radiation or chemotherapy for RPS have been unable to achieve sufficient enrollment. The completion of the STRASS trial, which explored neoadjuvant radiotherapy for primary resectable RPS, is a major milestone in RPS research, but has prompted further questions about histology-driven treatment paradigms for RPS. Though it was ultimately a negative trial with respect to its primary endpoint of abdominal recurrence-free survival, STRASS produced a signal that suggested improved abdominal recurrence-free survival with neoadjuvant radiotherapy (RT) for patients with liposarcoma (LPS). No effect was seen for leiomyosarcoma (LMS) or high-grade dedifferentiated (DD) LPS, consistent with recent literature suggesting LMS and high-grade DD-LPS have a predominant pattern of distant rather than local failure. These results, along with those from other recent studies conducted at the bench and the bedside, emphasize the importance of a histology-specific approach to RPS research. Recent evidence for patterns of distant failure in LMS and high-grade DD-LPS has prompted the initiation of STRASS2, a study of neoadjuvant chemotherapy for these histologies. As this study unfolds, evidence may emerge for novel systemic therapy options in specific sarcoma histotypes given the explosion in targeted and immunotherapeutic applications over the last decade. This article reviews current and recent evidence around neoadjuvant radiation and chemotherapy as well as avenues for future study to optimize these treatment approaches.
Language	English
Publishing date	2022-04-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers14071831
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