Unplanned Resection of Sarcoma. [Review]

MedStar author(s):
Citation: Journal of the American Academy of Orthopaedic Surgeons. 24(3):150-9, 2016 Mar.PMID: 26761037Institution: MedStar Washington Hospital CenterDepartment: Orthopedic OncologyForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Osteosarcoma/su [Surgery] | *Patient Care Planning/st [Standards] | *Sarcoma/su [Surgery] | *Soft Tissue Neoplasms/su [Surgery] | Health Care Costs | Humans | Malpractice | Osteosarcoma/di [Diagnosis] | Osteosarcoma/ep [Epidemiology] | Reoperation | Sarcoma/di [Diagnosis] | Sarcoma/ep [Epidemiology] | Soft Tissue Neoplasms/di [Diagnosis] | Soft Tissue Neoplasms/ep [Epidemiology] | Treatment OutcomeYear: 2016Local holdings: Available online from MWHC library: Oct 1993 - present, Available in print through MWHC library: 1999 - presentISSN:
  • 1067-151X
Name of journal: The Journal of the American Academy of Orthopaedic SurgeonsAbstract: Unplanned resection is a common problem in the management of sarcoma. Because sarcomas are so rare, they may be misdiagnosed initially as more common benign lesions. When the treating surgeon is unaware of or does not adhere to proper surgical principles of orthopaedic oncology, an intralesional procedure may be performed without the requisite preoperative imaging, staging, or wide resection margins for optimal management of sarcoma. Studies show that oncologic outcomes after unplanned resections are mixed; however, surgical outcomes drastically deteriorate. Failure to adhere to oncologic principles accounts for increased morbidity and amputation rates with re-resection. No diagnostic modality has been proven to accurately predict residual disease in the resection bed following unplanned resection. Thus, repeat surgery with or without adjuvant treatment is usually offered to these patients, thereby adding considerable cost and morbidity. Medical malpractice litigation associated with unplanned sarcoma resection is common, with delayed diagnosis and unnecessary amputation most often cited in cases decided in favor of the plaintiff.All authors: Henshaw RM, Tedesco NSFiscal year: 2016Digital Object Identifier: Date added to catalog: 2017-03-06
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 26761037 Available 26761037

Available online from MWHC library: Oct 1993 - present, Available in print through MWHC library: 1999 - present

Unplanned resection is a common problem in the management of sarcoma. Because sarcomas are so rare, they may be misdiagnosed initially as more common benign lesions. When the treating surgeon is unaware of or does not adhere to proper surgical principles of orthopaedic oncology, an intralesional procedure may be performed without the requisite preoperative imaging, staging, or wide resection margins for optimal management of sarcoma. Studies show that oncologic outcomes after unplanned resections are mixed; however, surgical outcomes drastically deteriorate. Failure to adhere to oncologic principles accounts for increased morbidity and amputation rates with re-resection. No diagnostic modality has been proven to accurately predict residual disease in the resection bed following unplanned resection. Thus, repeat surgery with or without adjuvant treatment is usually offered to these patients, thereby adding considerable cost and morbidity. Medical malpractice litigation associated with unplanned sarcoma resection is common, with delayed diagnosis and unnecessary amputation most often cited in cases decided in favor of the plaintiff.

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