Sarcoma and plastic surgery

Sarcomas are relatively uncommon tumours that can occur almost anywhere in the body. In the UK, 1,500 - 2,000 new cases of soft tissue sarcoma are diagnosed annually. 

There are particular challenges in managing patients with less common tumours and we know from studies that this group of patients does best, in terms of disease-free survival and overall survival, when they are managed in specialist sarcoma cancer centres by dedicated specialists in sarcoma. 

Soft tissue sarcomas are most appropriately dealt with by plastic surgeons in a specialist centre. Having plastic surgeons at the centre of the care team allows us to use our specialised reconstructive skills, such as microvascular free tissue transfer, to resect these complex tumours more widely and more radically. We are then in an ideal position to restore both form and function, and also to perform limb sparing surgery and avoid amputation of the limb.

Unfortunately, delays in diagnosis for sarcomas are common. Early diagnosis undoubtedly leads to improved outcomes both in terms of long term survival and less radical surgery. Here in Leeds we have developed a Rapid Access Referral Pathway for GPs and specialists which allows direct access to the sarcoma multidisciplinary team at the Regional Sarcoma Unit at Leeds General Infirmary. Patients are then assessed by a panel of surgeons, radiologists, oncologists, pathologists, physiotherapists and specialist nurses dedicated to the management and treatment of patients with suspected sarcoma or soft tissue tumours.

Patients referred to the Leeds Regional Sarcoma Unit with a suspected sarcoma or soft tissue tumour are initially assessed with an ultrasound scan of the lump. If the radiologist reports the swelling as suspicious then the patient progresses to an ultrasound guided biopsy and further imaging such as an MRI scan. The patient is then seen in the sarcoma - multidisciplinary team and their treatment planned by a panel of sarcoma specialists.

Ian Smith
BAPRAS Member