title: International expert opinion on patient-tailored management of soft tissue sarcomas.
abstract: BACKGROUND
  Soft tissue sarcomas (STS) are a heterogeneous group of cancers comprising over 50 histological subtypes. Current treatment strategies for sarcomas are increasingly adapted to histological and molecular subtype, and several patient- and tumour-related factors influence treatment decision.
  
  
  METHODS
  Seven oncologists specialising in the management of STS, from Europe, the United States of America and Japan, met to develop a practical model to identify parameters guiding treatment decision-making in advanced STS. Literature searches were carried out to identify key published evidence, in particular phase II and III randomised trials, to validate the model, and extensive clinical experience was used as expert evidence. A document was developed to provide a logical approach to advanced STS management and was analysed critically by a second group of STS specialists.
  
  
  RESULTS
  Broad consensus was reached during this exercise and the following parameters were identified as key factors influencing treatment decision: chemosensitivity of histological subtype, natural history of the diagnosis, tumour burden, tumour site, locally advanced primary and/or metastases, patient's general condition, relevant comorbidities, previous chemotherapy, treatment goal and patient acceptance. These parameters, judged useful for treatment selection, were based on published literature, the selection process within clinical trials and expert opinion (some factors have not been formerly defined in published literature).
  
  
  CONCLUSIONS
  A model describing factors affecting treatment decisions in sarcoma was established. The model requires validation and several of its parameters require standardisation.
authors.affiliation: Université Claude Bernard, Lyon, France. Electronic address: jean-yves.blay@lyon.unicancer.fr.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Blay
authors.affiliation: Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sleijfer
authors.affiliation: University Hospitals Leuven, KU Leuven, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Schöffski
authors.affiliation: National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kawai
authors.affiliation: Clinical Division of Oncology, Comprehensive Cancer Center - MusculoSkeletal Tumors, Medical University Vienna - General Hospital, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Brodowicz
authors.affiliation: Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: George D
authors.initials: GD
authors.lastname: Demetri
authors.affiliation: Mount Sinai Medical Center, NY, USA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Maki
mesh_terms: D000465:Algorithms; D032921:Consensus; D003657:Decision Making; D006801:Humans; D007391:International Cooperation; D008954:Models, Biological; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards*; D057285:Precision Medicine / Q000592:standards; D012509:Sarcoma / Q000628:therapy*
keywords: Management; Soft tissue sarcoma; Treatment