{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:07:06Z","timestamp":1779451626440,"version":"3.53.1"},"reference-count":108,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Presacral tumours are rare and heterogeneous lesions arising within a complex anatomical space, resulting in variability in diagnosis and management. Increasing incidental detection and evolving surgical and oncological strategies have highlighted the need for contemporary guidance. The aim of this study was to establish an international expert consensus on the optimal diagnosis and management of presacral tumours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An international panel of colorectal surgeons from high-volume units was convened. Evidence- and practice-based statements were developed after domain-based literature reviews and refined through five online and two in-person meetings. Consensus was achieved using a modified Delphi process with anonymous voting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 16 colorectal surgeons participated in the study. Ten domains were identified resulting in the development of 22 statements based on expert opinion and retrospective studies. After two rounds, unanimous (100%) agreement was achieved for all statements. High-resolution MRI with structured synoptic reporting is endorsed as central to risk stratification. Selective image-guided transperineal or parasacral biopsy is recommended for high-risk lesions where histology would alter management. Complete surgical resection is defined as the operative goal, with approach tailored to tumour biology and anatomy; minimally invasive surgery is considered appropriate in selected cases. Non-operative surveillance is supported for carefully selected asymptomatic, low-risk cystic lesions. Postoperative surveillance is recommended in a risk-adapted manner according to histopathology and margin status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This international consensus provides a pragmatic, risk-stratified framework for the multidisciplinary diagnosis and management of presacral tumours. These recommendations aim to reduce practice variation, support decision-making in specialized centres, and inform future prospective collaborative research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znag053","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:51:12Z","timestamp":1777377072000},"source":"Crossref","is-referenced-by-count":0,"title":["Presacral tumours: international consensus on diagnosis and management"],"prefix":"10.1093","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-8306","authenticated-orcid":false,"given":"William R G","family":"Perry","sequence":"first","affiliation":[{"name":"Division of Colon and Rectal Surgery, Mayo Clinic , Rochester, Minnesota ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kilian G M","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Royal Prince Alfred Hospital , Sydney, NSW ,","place":["Australia"]},{"name":"Surgical Outcomes Research Centre, University of Sydney , Sydney, NSW ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Burns","sequence":"additional","affiliation":[{"name":"Complex Cancer Clinic, St Mark\u2019s Hospital , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Denost","sequence":"additional","affiliation":[{"name":"Department of Surgery, Bordeaux Colorectal Institute , Bordeaux ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Frizelle","sequence":"additional","affiliation":[{"name":"Department of Surgery and Critical Care, University of Otago , Christchurch ,","place":["Aotearoa New Zealand"]},{"name":"Department of General Surgery, Te Whatu Ora Waitaha , Christchurch ,","place":["Aotearoa New 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