Heidi Buvarp Dyrop1,2, Akmal Safwat3, Peter Vedsted4, Katja Maretty-Kongstad5, Bjarne Hauge Hansen2, Peter Holmberg Jørgensen2, Thomas Baad-Hansen2, Johnny Keller2. 1. Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus C, Denmark. 2. Department of Orthopedics, Sarcoma Center of Aarhus University Hospital, Aarhus C, Denmark. 3. Department of Oncology, Sarcoma Center of Aarhus University Hospital, Aarhus C, Denmark. 4. The Research Unit for General Practice, Aarhus University, Aarhus C, Denmark. 5. Department of Pathology, Sarcoma Center of Aarhus University Hospital, Aarhus C, Denmark.
Abstract
BACKGROUND AND METHODS: Unplanned excision of sarcoma before referral to specialist centers can affect prognosis and surgical outcome. The diagnostic pathway of these patients is uncertain and needs to be reviewed. We aimed to describe patient and tumor characteristics, initial symptoms, initial and final diagnosis, and explore reasons for unplanned excision in this patient group. From a previous study on 258 sarcoma patients, we identified 64 patients referred after surgery. Medical records were reviewed. RESULTS: The majority were soft tissue sarcomas, most often with thoracic location. Leiomyosarcoma was the most frequent final diagnosis, lipoma, and fibroma/dermatofibroma the most frequent initial diagnoses. Fifty percent were superficial small tumors, and 60.9% had not received diagnostic imaging before surgery. Fifty percent were referred from public surgical departments, and 1/3 from private specialists. Twenty-three patients had initial presence of alarm symptoms registered before surgery, the remaining 2/3 fell outside referral criteria or alarm symptoms were not discovered. CONCLUSIONS: Patients referred after unplanned excision often have small superficial tumors and the majority fall outside of defined referral criteria. Referral criteria are not a guarantee for detection of all sarcomas and surgeons should always be aware of the possibility of malignancy when removing a tumor.
BACKGROUND AND METHODS: Unplanned excision of sarcoma before referral to specialist centers can affect prognosis and surgical outcome. The diagnostic pathway of these patients is uncertain and needs to be reviewed. We aimed to describe patient and tumor characteristics, initial symptoms, initial and final diagnosis, and explore reasons for unplanned excision in this patient group. From a previous study on 258 sarcomapatients, we identified 64 patients referred after surgery. Medical records were reviewed. RESULTS: The majority were soft tissue sarcomas, most often with thoracic location. Leiomyosarcoma was the most frequent final diagnosis, lipoma, and fibroma/dermatofibroma the most frequent initial diagnoses. Fifty percent were superficial small tumors, and 60.9% had not received diagnostic imaging before surgery. Fifty percent were referred from public surgical departments, and 1/3 from private specialists. Twenty-three patients had initial presence of alarm symptoms registered before surgery, the remaining 2/3 fell outside referral criteria or alarm symptoms were not discovered. CONCLUSIONS:Patients referred after unplanned excision often have small superficial tumors and the majority fall outside of defined referral criteria. Referral criteria are not a guarantee for detection of all sarcomas and surgeons should always be aware of the possibility of malignancy when removing a tumor.
Authors: Shai S Shemesh; Erika L Garbrecht; Tal Frenkel Rutenberg; Sheila A Conway; Andrew E Rosenberg; Juan Pretell-Mazzini Journal: Int Orthop Date: 2021-08-20 Impact factor: 3.075
Authors: Maria Anna Smolle; Per-Ulf Tunn; Elisabeth Goldenitsch; Florian Posch; Joanna Szkandera; Marko Bergovec; Bernadette Liegl-Atzwanger; Andreas Leithner Journal: Ann Surg Oncol Date: 2017-01-20 Impact factor: 5.344