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Soft tissue sarcoma: treatment as per the Austrian guidelines improve prognosis

(Vienna, 19th February 2014) Soft tissue tumours are a rare form of cancer. Studies confirm that rapid referral to specialist centres can significantly improve a patient’s prognosis. A treatment protocol drawn up with the considerable involvement of experts from the Comprehensive Cancer Center (CCC) at the MedUni Vienna and the Vienna General Hospital lists the latest gold standards for decision-making criteria. Two years after its publication, the authors are hailing the protocol a success.

Around 240 to 300 cases of soft tissue sarcoma (tumours of the connective, fatty and muscle tissue) are diagnosed in Austria each year. The outcome is always more favourable the sooner appropriate treatment is instigated. The Austrian consensus paper, “Consensus on the Diagnosis and Treatment of Soft Tissue Sarcomas”, provides guidelines based on the latest scientific findings that define how patients who are suspected of having a soft tissue sarcoma should be treated. These guidelines have been developed by sarcoma experts at Austria’s major specialist centres based at the three university hospitals of Vienna, Graz and Innsbruck (Thomas Brodowicz et al., Wien Klin. Wochenschr. (2012) 124:85-99 DOI 10.1007/s00508-011-0079-8, Springer Verlag 2012).

Reinhard Windhager, Head of the University Department of Orthopaedics at the MedUni Vienna, Head of the MST (Musculoskeletal Tumours Unit) CCC Unit and primary author, says: “The aim was to create a set of guidelines that also supports clinicians who rarely see soft tissue tumours. The plan is to ensure that referrals are made promptly to a specialist centre.”

Now, two years after the guidelines were introduced, Windhager is happy to report positive results: “Collaboration with registered practitioners and non-specialist hospitals has been stepped up, and patients are being referred to us much more effectively. This helps improve their prognosis, because they are treated by a facility that specialises in their condition.”

Austrian Guidelines
The treatment of soft tissue sarcomas represents an inter-disciplinary challenge that requires the cooperation of surgeons, radiotherapists, oncologists, pathologists and radiologists. Says Windhager: “The therapeutic approach is multi-modal in nature and requires a corresponding infrastructure and experience in the delivery of such complex therapies. This is the only way to achieve the best possible result for the patient. Everyone affected by this condition should therefore be treated without exception at one of the three Austrian university centres."

Key points in the guidelines include, among others, instructions on how to correctly investigate suspicious lesions, the definition of the role of pathology in the planning of the diagnostic biopsy, recommendations on surgical management and criteria for deciding the use of adjuvant and neo-adjuvant radiotherapy, radiochemotherapy and chemotherapy.

For the purposes of the Austrian consensus paper, the Guidelines of the European Society of Medical Oncology (ESMO) and the National Comprehensive Cancer Centre Network (NCCN) were adapted to Austrian requirements, including everyday clinical practice, the organisations available and local needs.

Service: Consensus on the Diagnosis and Treatment of Soft Tissue Sarcomas
Thomas Brodowicz, Gabriele Amann, Andreas Leithner, Arpad Sztankay, Franz Kainberger, Wolfgang Eisterer, Bernadette Liegl-Atzwanger, Franz Rachbauer, Thomas Rath, Michael Bergmann, Philipp T. Funovics, Ferdinand Ploner, Reinhard Windhager. Wien Klin Wochenschr (2012) 124:85-99 DOI 10.1007/s00508-011-0079-8, Springer Verlag 2012.