Research Article| Volume 49, ISSUE 6, P1125-1132, June 2023

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Follow-up of patients with retroperitoneal sarcoma

Published:March 03, 2022DOI:


      Retroperitoneal sarcomas (RPS) are rare malignancies that are potentially curable by complete surgical resection. A regular surveillance program is normally commenced following surgery due to the risk of local recurrence (LR), especially in low-intermediate grade disease, and distant metastases (DM), especially in high-grade RPS. Consensus guidelines usually advocate for more frequent imaging during the first 2–3 years and less intensive imaging over a prolonged period thereafter, reflecting the incidence pattern of LR and DM. Definitive evidence for the most effective imaging schedule has never been provided, and retrospective studies have not shown an association between follow-up intensity and survival. Improvement in the prediction of recurrence patterns has been sustained by prognostic dynamic nomograms, which are now capable of forecasting disease behaviour in each patient according to specific features. Incorporation of such tools in clinical practice may help to stratify patients and tailor ongoing surveillance to the risk of recurrence. This may help to relieve patients’ anxiety while awaiting results of surveillance investigations, and also reduce the economic and environmental burden of repeated imaging. A randomized controlled study (SARveillance Trial) is proposed to shed light on this controversial topic, allowing clinicians to harmonize the follow-up protocol of patients undergoing surgery for RPS.


      RPS (retroperitoneal soft tissue sarcoma), LR (local recurrence), DM (distant metastasis), OS (overall survival), FNCLCC (Fédération Nationale des Centres de Lutte Contre Le Cancer), HR-QoL (health-related quality of life), ESMO (European Society for Medical Oncology), STS (soft tissue sarcoma), SAFETY (Surveillance AFter Extremity Tumoursurgery), CT (computed tomography), TOSS (Trial for Optimal Surveillance in Sarcomas), NCCN (National Comprehensive Cancer Network), TARPSWG (Transatlantic Australasian Retroperitoneal Sarcoma Working Group), EURCAN (European Reference Network for Rare Adult Solid Cancers), GENTURIS (European Reference Network for Genetic Tumour Risk Syndromes), MRI (magnetic resonance imaging), WDLPS (well-differentiated liposarcoma), DDLPS (de-differentiated liposarcoma), EORTC (European Organisation for Research and Treatment of Cancer), QLQ-C30 (Quality of life - Core questionnaire)
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