Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Nearly half of sarcoma surgeries done by nonsurgical oncology specialists

09.07.2013
Orthopedic oncologists and surgical oncologists, who have been trained in the complex procedures required to remove sarcomas located deep in the muscles and other soft tissues of the limbs, conducted only 52 percent of these operations at 85 academic medical centers during a three year period, according to an analysis of national data by UC Davis researchers that is published online today in the Journal of Surgical Oncology.

The remaining 48 percent of these sarcoma surgeries were conducted by general surgeons, plastic surgeons and orthopedic surgeons, whose post-medical degree fellowship training did not emphasize the multi-disciplinary evaluation and surgical management of sarcomas and other cancers located deep in the soft tissue of the arms and legs, said Robert J. Canter, associate professor of surgery at UC Davis and first author of the journal article.

The UC Davis study is the first to examine the overall frequency and distribution nationwide of the different surgical specialists who remove sarcomas and other deep-seated tumors in the soft tissue of patients’ limbs.

“Our findings may have significant implications for the quality of care provided to patients who undergo surgery to resect, or remove, sarcomas in the deep soft tissue of the limbs,” said Canter, a surgical oncologist.

Canter explained that only orthopedic oncologists and surgical oncologists, but not general surgeons, plastic surgeons and orthopedic surgeons, have been trained in how to remove sarcomas from muscles and other soft tissue without leaving behind cancerous cells that could trigger another tumor. Studies have shown that achieving tumor-free margins improves the long-term survival of cancer patients.

Patients whose sarcomas are not diagnosed until after the surgery often require a second operation to remove remaining cancer cells, Canter said. A repeat operation puts the patient at risk again for surgical complications, he noted.

A sarcoma can be diagnosed before surgery by needle biopsy. However, because sarcomas are rare, many general surgeons, plastic surgeons and orthopedic surgeons may not consider that the tumor could be a sarcoma before operating on the patient, Canter said.

According to the American Cancer Society, about 11,410 new soft tissue sarcomas will be diagnosed and 4,390 Americans are expected to die of soft tissue sarcomas in 2013. About 50 percent of soft tissue sarcomas occur in the limbs.

Most tumors in muscles and other soft tissue are sarcomas, said Canter. Approximately 50 percent of these sarcomas are at risk for spreading to other tissues in the body.

When the tumor is diagnosed as a sarcoma before the operation, the surgeon can carefully evaluate the cancer to determine whether radiation or chemotherapy will be needed to reduce the size of the tumor and whether a plastic surgeon or a vascular surgeon should be part of the surgical team. Canter said a patient’s need for physical therapy or occupational therapy after the operation also is taken into consideration during the pre-surgical evaluation and planning period.

These considerations led both the U.S. National Comprehensive Cancer Network and European Society of Medical Oncology to develop guidelines recommending that surgeons with expertise and training in the management of soft tissue sarcomas should operate on patients with tumors that may be sarcomas.

The UC Davis researchers’ analysis also revealed that 17% of these operations were performed during 2007 to 2009 by surgeons who conducted an average of only one or two of these surgeries each year. Previous studies have shown that better clinical outcomes result when the surgeon performs a greater volume of these specialized operations.

Canter and his collaborators determined that during 2007 to 2009 sarcoma surgeries were performed by 2,195 general surgeons, 1,979 general orthopedic surgeons, 792 plastic surgeons, 533 surgical oncologists and 83 orthopedic oncologists.

Adjusting for the number of physicians in the database, Canter and his collaborators determined that the mean number of deep soft tissue tumor removals from the extremities, including sarcomas, per specialty was: 9.4 percent for general surgeons, 7.7 percent for plastic surgeons, 26 percent by surgical oncologists, 30.8 percent by general orthopedic surgeons and 26 percent by orthopedic oncologists.

In contrast, the mean number of operations to remove soft tissue tumors that were not sarcomas and that were located subcutaneously, or under the skin, did not differ significantly among general surgeons, orthopedic surgeons, plastic surgeons, surgical oncologists and orthopedic oncologists.

For their analysis, the researchers used the Faculty Practice Solution Center database administered by the University Health System Consortium and the Association of American Medical Colleges.

Because the database does not include information about clinical outcomes, Canter and his colleagues were unable to associate each surgical specialty to a rate of postsurgical complications or post-surgical survival.

The Journal of Surgical Oncology paper is titled, “Extremity Soft Tissue Tumor Surgery by Surgical Specialty: A Comparison of Case Volume Among Oncology and Non-Oncology-Designated Surgeons.”

Additional study authors are Caitlin A. Smith, Steve R. Martinez, James E. Goodnight, Richard J. Bold and David H. Wisner, all of UC Davis.

The study was funded by the Department of Surgery at the UC Davis Health System.

UC Davis Comprehensive Cancer Center
UC Davis Comprehensive Cancer Center is the only National Cancer Institute-designated center serving the Central Valley and inland Northern California, a region of more than 6 million people. Its specialists provide compassionate, comprehensive care for more than 9,000 adults and children every year, and access to more than 150 clinical trials at any given time. Its innovative research program engages more than 280 scientists at UC Davis, Lawrence Livermore National Laboratory and Jackson Laboratory (JAX West), whose scientific partnerships advance discovery of new tools to diagnose and treat cancer. Through the Cancer Care Network, UC Davis collaborates with a number of hospitals and clinical centers throughout the Central Valley and Northern California regions to offer the latest cancer care. Its community-based outreach and education programs address disparities in cancer outcomes across diverse populations.

Dorsey Griffith | EurekAlert!
Further information:
http://cancer.ucdavis.edu

More articles from Health and Medicine:

nachricht Plasmonic biosensors enable development of new easy-to-use health tests
14.12.2017 | Aalto University

nachricht ASU scientists develop new, rapid pipeline for antimicrobials
14.12.2017 | Arizona State University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Long-lived storage of a photonic qubit for worldwide teleportation

MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.

Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...

Im Focus: Electromagnetic water cloak eliminates drag and wake

Detailed calculations show water cloaks are feasible with today's technology

Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...

Im Focus: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

Im Focus: Successful Mechanical Testing of Nanowires

With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong

Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

Plasmonic biosensors enable development of new easy-to-use health tests

14.12.2017 | Health and Medicine

New type of smart windows use liquid to switch from clear to reflective

14.12.2017 | Physics and Astronomy

BigH1 -- The key histone for male fertility

14.12.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>