Abstract：
BACKGROUND: The Royal Prince Alfred Hospital (RPAH) and Chris O\'Brien Lifehouse (COBLH) established a formal Sarcoma of the Pelvic and Abdominal Retroperitoneum Collaboration (SPARC) in November 2020. An established multidisciplinary team (MDT) with the aims to centralise patient referrals and treatment, establish database and research, coordinate surgical resections is critical in improving patient outcomes and quality of life.
METHODS: A prospective database was established in October 2021. Clinical, pathological and radiological data points were recorded for all patients since the inception of SPARC. Quality of Life questionnaires were included and follow-up planned regularly for 5 years.
RESULTS: From November 2020 to Feb 2024, 294 new referrals were discussed at the MDT meeting. Majority were from the metropolitan area (182) followed by regional NSW (87), interstate (20) and five internationals. 141 operations were performed during this period compared to 119 operations from 2010 to November 2020 in RPAH. The inception of the SPARC program has resulted in exponential growth in operations, improving from the previous rate of 15 cases annually to 35. Liposarcomas followed by leiomyosarcomas are the most common types of sarcomas resected. The majority were extended resections (81.6%) and 22% were pelvic exenterations. Overall R0 rate is 54.6%, R1 38.3% and R2 1.4% (131 (92.9%) had R0/R1 resections. Overall complication rate is 35.5% with one in-hospital mortality.
CONCLUSIONS: Success and expansion of a robust retroperitoneal sarcoma program requires a collaborative surgical approach, an MDT meeting, centralized referral process, and a research team in specialized tertiary institutions.
METHODS: A prospective database was established in October 2021. Clinical, pathological and radiological data points were recorded for all patients since the inception of SPARC. Quality of Life questionnaires were included and follow-up planned regularly for 5 years.
RESULTS: From November 2020 to Feb 2024, 294 new referrals were discussed at the MDT meeting. Majority were from the metropolitan area (182) followed by regional NSW (87), interstate (20) and five internationals. 141 operations were performed during this period compared to 119 operations from 2010 to November 2020 in RPAH. The inception of the SPARC program has resulted in exponential growth in operations, improving from the previous rate of 15 cases annually to 35. Liposarcomas followed by leiomyosarcomas are the most common types of sarcomas resected. The majority were extended resections (81.6%) and 22% were pelvic exenterations. Overall R0 rate is 54.6%, R1 38.3% and R2 1.4% (131 (92.9%) had R0/R1 resections. Overall complication rate is 35.5% with one in-hospital mortality.
CONCLUSIONS: Success and expansion of a robust retroperitoneal sarcoma program requires a collaborative surgical approach, an MDT meeting, centralized referral process, and a research team in specialized tertiary institutions.
摘要：
背景：皇家阿尔弗雷德王子医院（RPAH）和克里斯·奥布赖恩救生所（COBLH）于2020年11月建立了正式的盆腔和腹部腹膜后肉瘤协作（SPARC）。已建立的多学科团队（MDT）旨在集中患者转诊和治疗，建立数据库和研究，协调手术切除对改善患者预后和生活质量至关重要.
方法：于2021年10月建立了前瞻性数据库。临床,自SPARC开始治疗以来,我们记录了所有患者的病理学和放射学数据点.纳入生活质量问卷，并计划定期随访5年。
结果：从2020年11月到2024年2月，在MDT会议上讨论了294个新的转介。大多数人来自大都市区（182），其次是新南威尔士州（87），州际（20）和五个国际。在此期间进行了141次操作，而2010年至2020年11月在RPAH进行了119次操作。SPARC计划的开始导致运营呈指数级增长，从以前的每年15例病例增加到35例。脂肪肉瘤，其次是平滑肌肉瘤是切除的最常见的肉瘤类型。大多数为延长切除（81.6％），22％为盆腔切除术。整体R0率为54.6%,R138.3％和R21.4％（131（92.9％）进行了R0/R1切除。总并发症发生率为35.5％，其中1例住院死亡率。
结论：强大的腹膜后肉瘤计划的成功和扩展需要协作的手术方法，MDT会议,集中推荐流程，和专门的大专院校的研究团队。
方法：于2021年10月建立了前瞻性数据库。临床,自SPARC开始治疗以来,我们记录了所有患者的病理学和放射学数据点.纳入生活质量问卷，并计划定期随访5年。
结果：从2020年11月到2024年2月，在MDT会议上讨论了294个新的转介。大多数人来自大都市区（182），其次是新南威尔士州（87），州际（20）和五个国际。在此期间进行了141次操作，而2010年至2020年11月在RPAH进行了119次操作。SPARC计划的开始导致运营呈指数级增长，从以前的每年15例病例增加到35例。脂肪肉瘤，其次是平滑肌肉瘤是切除的最常见的肉瘤类型。大多数为延长切除（81.6％），22％为盆腔切除术。整体R0率为54.6%,R138.3％和R21.4％（131（92.9％）进行了R0/R1切除。总并发症发生率为35.5％，其中1例住院死亡率。
结论：强大的腹膜后肉瘤计划的成功和扩展需要协作的手术方法，MDT会议,集中推荐流程，和专门的大专院校的研究团队。
