Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Zacherl, M; Kastner, N; Glehr, M; Scheipl, S; Schwantzer, G; Koch, H; Leithner, A; Windhager, R; .
Influence of Prereferral Surgery in Soft Tissue Sarcoma: 10 Years' Experience in a Single Institution.
Orthopedics. 2012; 35(8):e1214-e1220
Doi: 10.3928/01477447-20120725-22
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Zacherl Maximilian
- Co-Autor*innen der Med Uni Graz
- Glehr Mathias
- Kastner Norbert
- Koch Horst
- Leithner Andreas
- Scheipl Susanne
- Schwantzer Gerold
- Windhager Reinhard
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- Abstract:
- Soft tissue sarcomas are a group of rare mesenchymal neoplasms comprising 0.8% of all malignant tumors. Workup should include medical history, physical examination, magnetic resonance imaging, biopsy, and thoracoabdominal computed tomography scan, in that order. Centralized multimodality treatment in a cross-disciplinary setting is mandatory. Treatment not according to current clinical practice guidelines is a common problem before referral to a specialized institution. The purpose of this 10-year, single-institution review was to investigate the influence of curative surgery on outcome, with a special emphasis on surgery before referral. A cohort of 266 patients who underwent curative surgery for soft tissue sarcoma between 1998 and 2008 was analyzed. One hundred thirty-one (49%) patients underwent surgery contrary to current clinical guidelines before referral, most (73%) at primary care units. One hundred thirteen (86%) of these patients underwent surgery without previous biopsy with a higher rate of intralesional margins (P<.001), a smaller mean diameter of primary lesion (P<.001), a higher rate of subcutaneous situs (P<.001), a lower mean American Joint Committee on Cancer score (P=.008), a higher rate of additional plastic surgery after re-resection (eg, flap surgery) (P<.001), and a longer period before referral (P<.001). No influence on survival, local recurrence, or metastasis existed. Prereferral surgery necessitating re-resection has no influence on survival but leads to an unfavorable clinical course. More effort should be made to improve awareness and referral modalities for general practitioners and physicians at community hospitals.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Aged -
- Aged, 80 and over -
- Child -
- Cohort Studies -
- Female -
- Humans -
- Male -
- Medical Errors -
- Middle Aged -
- Referral and Consultation -
- Sarcoma - diagnosis Sarcoma - therapy
- Soft Tissue Neoplasms - diagnosis Soft Tissue Neoplasms - therapy
- Young Adult -