What are the Trans-Atlantic Retroperitoneal Sarcoma Working Group guidelines for assessment of soft tissue sarcoma (STS)?

Updated: Sep 02, 2018
  • Author: Steven C Katz, MD, FACS; Chief Editor: Edwin Choy, MD, PhD  more...
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Answer

Answer

Recommendations are as follows:

  • Review of cross-sectional imaging by a dedicated tumor board is required.
  • CT of the chest, abdomen, and pelvis with intravenous contrast is the preferred imaging modality. MRI is an option for patients with contrast allergy, for pelvic tumors, or for cases in which detailed anatomic information (eg, sciatic foramen) is required.
  • Functional assessment of the contralateral kidney is generally required prior to resection.
  • Image-guided core needle biopsy is recommended unless the imaging is definitive, such as in the case of well-differentiated/de-differentiated liposarcoma. Fine-needle aspiration biopsy should be avoided, as it is generally unhelpful.
  • Open or laparoscopic surgical biopsy should be avoided. If an RPS is encountered unexpectedly at surgery, management should be deferred until proper imaging and tissue sampling can be performed by an expert soft tissue sarcoma (STS) team.

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