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The European School of Soft Tissue Sarcoma Illustrated 25/08/2017

Less than one year ago, ESSO and the Connective Tissue Oncology Society (CTOS) jointly launched the European School of Soft Tissue Sarcoma Surgery (ESSTSS). During the ESSO 36 Congress, we had the opportunity to interview Dr. Marco Fiore (Istituto dei Tumori, Milan, Italy), Director of the School 2016-2020 and expert in soft tissue sarcoma surgery.

He explained that the need to provide structured training in the surgical management of soft tissue sarcomas comes from the peculiar aspects of these malignancies, which require a multidisciplinary approach encompassing both abdominal surgery and surgery of the muscular skeletal tissue. Soft tissue sarcoma is a family of diseases which includes retroperitoneal sarcoma, limbs sarcoma, trunk sarcoma, and GISTs. Basic and clinical research of mesenchymal neoplasms is an a essential part of their clinical management; therefore comprehensive training must be provided.

There are multiple courses in Europe focused on soft tissue sarcomas, but there are currently no structured training programmes or formal recognition of proficiency in the surgical approach to these type of malignancies. The European School of Soft Tissue Sarcoma Surgery (ESSTSS) will therefore integrate the existing courses in a 2-year long educational path, resulting in the European Certification in Soft Tissue Sarcoma Surgery. This certification will be awarded to successful candidates who master the scientific basis and clinical practice of soft tissue sarcoma care, specifically multidisciplinary decision-making and surgical management.

The ESSTSS engages four different healthcare centres located in different parts of Europe (Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Institut Curie, Paris, France; Royal Marsden Hospital, London, UK; Antoni van Leeuwenhoek Nederlands Kanker Instituut, Amsterdam, the Netherlands), each with a specific expertise in the treatment of soft tissue sarcoma, visceral sarcomas and sarcomas of the extremities. During the 2 year programme, students are expected to spend at least at least 6 months in two of the four European reference centres.

Soft tissue sarcomas are rare pathologies whose heterogeneity from a molecular and anatomic standpoint result in high variables between treatment protocols and multidisciplinary best practice standards. Fiore explains that “as this is a very selective sector, the school will enrol only a few participants each time”. The participant profile can be either one of a young surgeon willing to take part in a sarcoma programme, or an experienced surgeon at an advanced stage of his/her medical career who wants to strengthen the collaboration with other reference centres in Europe.

Over the duration of the course, participants need to directly participate in the execution of several surgical procedures to treat retroperitoneal sarcoma, limb and truncal soft tissue sarcoma, and GIST, to attend multidisciplinary tumour board meetings and to submit a final research study at the end of the course, which will be shared among the four centres. “The day-to-day organisation of the studies is flexible, but the idea is for participants to take part in all the clinical and/or activities regarding GIST surgery, retro-peritoneal surgery, limb surgery, etc.” Fiore continued. Each candidate is assigned a tutor; a reference person located in one of the four centres whose task will be to support the student, verify his/her progress and answer all questions related to the research project.  

In addition to  recognition from ESSO, Fiore explained that the collaboration with CTOS was required as this scientific society has a wide multidisciplinary approach to soft tissue sarcomas’ basic science, pathology, surgery, medical oncology, and radiation oncology. Indeed, apart from the residency in 2 of the 4 specialised centres, the School programme foresees the attendance to the CTOS Annual Meeting, among other specialised events (the ESSO Congress, the ESMO Sarcoma & GIST Conference, and ESurge).

This comprehensive programme is expected to enjoy similar success as the European School of Peritoneal Surface Oncology, which was implemented in 2015 in partnership with PSOGI (Peritoneal Surface Oncology Group International) and has now benefitted a total of nearly 30 participants. With this exclusive initiative, ESSO wishes to provide structured training in the surgical management of soft tissue sarcoma, a highly demanding and specialised field of cancer surgery.

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