July 31, 2009
BIRMINGHAM, Ala. - Patients with a suspected benign soft tissue tumor who get an early referral to a cancer specialist have better outcomes in the event the tumor proves to be a malignant sarcoma, say investigators at the University of Alabama at Birmingham (UAB). Sarcomas are cancers that develop in soft tissue, such as muscles or cartilage, and not in organs.
In findings published in the summer issue of the Journal of Surgical Orthopaedic Advances, the UAB team, led by Herrick Siegel, M.D., associate professor of orthopaedic surgery, says men aged 20-40 with a soft tissue mass discovered following a traumatic injury incurred at work or during recreational activities are more likely to have that tumor removed during an unplanned procedure without consultation or participation from specialists trained in cancer treatment. Sarcoma may commonly be misdiagnosed in this age group as hematomas, muscle tears, sprains, ganglion cysts and lipomas.
Such patients who undergo an unplanned excision are at increased risk for developing complications at the site of the tumor and may require additional treatment such as radiation and chemotherapy, which may have been avoided with early referral to a cancer specialist before a biopsy is done.
"It is vital that patients with a soft tissue mass be seen by a multidisciplinary team consisting of radiologists, pathologists and surgeons trained in sarcoma management," said Siegel, lead author of the study. "Tumor excision by a non-oncologic surgeon may leave minute parts of the tumor behind, allowing it to grow back."
Siegel says that outcomes for sarcoma patients treated at cancer centers are much better than for those treated outside of a cancer center. There is less chance that the cancer will return, and less likelihood that major reconstructive surgery, or even amputation of a limb, would be necessary.
"Early referral to a sarcoma specialist can avoid many of the complications that occur when excisions are performed at non-oncologic centers," he says. "The key is having a suspect soft tissue mass biopsied at a cancer center to determine if it is malignant or not."
About UAB Orthopaedic Oncology
The UAB Orthopaedic Oncology team includes specialists in hematology/oncology, orthopaedic oncology, radiology, rehabilitation medicine, surgical oncology. They can provide all available treatment modalities since specialists in surgery, radiation therapy, and chemotherapy are part of the team. Often patients may benefit from a combination of these treatments, which requires a team of specialists who can pool their expertise and work closely together.