2024年肉瘤挑战会议（CCS）：关于非循证管理方面的专家意见
Conference on challenges in sarcoma (CCS) 2024: Expert opinions on non-evidence-based management aspects.
作者信息
Hofer Silvia, Pauli Chantal, Bode Beata, Bonvalot Sylvie, Fotopoulou Christina, Gelderblom Hans, Haas Rick L, Hardes Jendrik, Hohenberger Peter, Jakob Jens, Kunz Wolfgang G, Leithner Andreas, Liegl-Atzwanger Bernadette, Lindner Lars, Miah Aisha, Reichardt Peter, Rutkowski Piotr, Schaarschmidt Benedikt M, Scheinemann Katrin, Szkandera Joanna, Wardelmann Eva, Andreou Dimosthenis, Rothermundt Christian
机构信息
Institute of Pathology, University Hospital, Zürich, Zürich Switzerland.
Institute of Pathology and Molecular Pathology, University Hospital, Zürich, Zürich Switzerland.
出版信息
Eur J Cancer. 2025 May 2;220:115368. doi: 10.1016/j.ejca.2025.115368. Epub 2025 Mar 17.
BACKGROUND
Soft tissue sarcomas (STS) and other mesenchymal tumours belong to rare, heterogeneous neoplasms with over 150 subtypes that pose significant challenges in diagnosis and clinical decision making. While guidelines address evidence-based diagnostic and therapeutic procedures, clinical situations and scenarios without evidence remain controversial in daily practice. The 2024 Conference on Challenges in Sarcoma (CCS2024) aimed to narrow these gaps with the support of an international and multidisciplinary panel of sarcoma experts.
METHODS
A Delphi process identified 200 controversial questions across eight prioritised clinical scenarios, including tenosynovial giant cell tumour, synovial sarcoma of the extremities, retroperitoneal sarcomas, angiosarcoma, phyllodes tumour, malignant peripheral nerve sheath tumour, uterine leiomyosarcoma, and atypical lipomatous tumour.
RESULTS
Sixty-four experts discussed 141 controversies during the conference and reached strong consensus (> 90 %) on 24 and consensus (> 75 %) on 45 key diagnostic and therapeutic issues, while unresolved controversies emphasized the need for further research.
CONCLUSIONS
CCS2024 provides a framework for clinical decision making and underscores the importance of consensus-driven approaches in the treatment of rare and complex malignancies.
背景
软组织肉瘤（STS）和其他间充质肿瘤属于罕见的异质性肿瘤，有超过150种亚型，在诊断和临床决策方面带来重大挑战。虽然指南涉及循证诊断和治疗程序，但在日常实践中，缺乏证据的临床情况和场景仍存在争议。2024年肉瘤挑战会议（CCS2024）旨在在国际多学科肉瘤专家小组的支持下缩小这些差距。
方法
德尔菲法在八个优先临床场景中确定了200个有争议的问题，包括腱鞘巨细胞瘤、四肢滑膜肉瘤、腹膜后肉瘤、血管肉瘤、叶状肿瘤、恶性外周神经鞘瘤、子宫平滑肌肉瘤和非典型脂肪瘤样肿瘤。
结果
64位专家在会议期间讨论了141个争议问题，对24个关键诊断和治疗问题达成了强烈共识（>90%），对45个问题达成了共识（>75%），而未解决的争议强调了进一步研究的必要性。
结论
CCS2024为临床决策提供了一个框架，并强调了共识驱动方法在治疗罕见和复杂恶性肿瘤中的重要性。
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