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 UC San Diego researchers develop sensors to detect and measure cancer's ability to spread
06.12.2018 | University of California - San Diego

nachricht New cancer immunotherapy approach turns immune cells into tiny anti-tumor drug factories
05.12.2018 | University of California - San Diego

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: Researchers develop method to transfer entire 2D circuits to any smooth surface

What if a sensor sensing a thing could be part of the thing itself? Rice University engineers believe they have a two-dimensional solution to do just that.

Rice engineers led by materials scientists Pulickel Ajayan and Jun Lou have developed a method to make atom-flat sensors that seamlessly integrate with devices...

Im Focus: Three components on one chip

Scientists at the University of Stuttgart and the Karlsruhe Institute of Technology (KIT) succeed in important further development on the way to quantum Computers.

Quantum computers one day should be able to solve certain computing problems much faster than a classical computer. One of the most promising approaches is...

Im Focus: Substitute for rare earth metal oxides

New Project SNAPSTER: Novel luminescent materials by encapsulating phosphorescent metal clusters with organic liquid crystals

Nowadays energy conversion in lighting and optoelectronic devices requires the use of rare earth oxides.

Im Focus: A bit of a stretch... material that thickens as it's pulled

Scientists have discovered the first synthetic material that becomes thicker - at the molecular level - as it is stretched.

Researchers led by Dr Devesh Mistry from the University of Leeds discovered a new non-porous material that has unique and inherent "auxetic" stretching...

Im Focus: The force of the vacuum

Scientists from the Theory Department of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science (CFEL) in Hamburg have shown through theoretical calculations and computer simulations that the force between electrons and lattice distortions in an atomically thin two-dimensional superconductor can be controlled with virtual photons. This could aid the development of new superconductors for energy-saving devices and many other technical applications.

The vacuum is not empty. It may sound like magic to laypeople but it has occupied physicists since the birth of quantum mechanics.

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

EGU 2019 meeting: Media registration now open

06.12.2018 | Event News

Expert Panel on the Future of HPC in Engineering

03.12.2018 | Event News

Inaugural "Virtual World Tour" scheduled for december

28.11.2018 | Event News

 
Latest News

A new molecular player involved in T cell activation

07.12.2018 | Life Sciences

High-temperature electronics? That's hot

07.12.2018 | Materials Sciences

Supercomputers without waste heat

07.12.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>