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A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing Neoadjuvant Therapies
Published on: July 28, 2020
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Unplanned Sarcoma Excisions: Understanding How They Happen
Ana Cecilia Belzarena1, Odion Binitie, George Douglas Letson
1From the Department of Orthopedic Surgery, University of Missouri, Columbia, MO (Dr. Belzarena), and the Sarcoma Department, Moffitt Cancer Center, Tampa, FL (Dr. Binitie, Dr. Letson, and Dr. Joyce).
Summary
Unplanned excisions of soft-tissue sarcomas are common, often due to diagnostic errors and inadequate imaging. Orthopaedic surgeons frequently perform these procedures, highlighting a need for improved sarcoma management protocols.
Area of Science:
- Oncology
- Surgical Pathology
- Medical Diagnostics
Background:
- Soft-tissue sarcomas often present with vague symptoms, leading to common unplanned excisions.
- Unplanned excisions can complicate treatment and affect patient outcomes.
Purpose of the Study:
- To determine the incidence of unplanned excisions performed by orthopaedic surgeons.
- To conduct a root cause analysis (RCA) of factors contributing to unplanned sarcoma excisions.
Main Methods:
- Retrospective case-control study comparing patients with unplanned excisions to those managed at a sarcoma center.
- Root cause analysis (RCA) applied to identify preventable causes of unplanned excisions.
Main Results:
- Orthopaedic surgeons were the second most frequent group performing unplanned excisions.
- Inadequate or absent imaging occurred in 76.6% of cases; 42.1% had no imaging prior to procedure.
- Key obstacles included misdiagnosis, inadequate imaging, and biopsy errors.
Conclusions:
- Unplanned excisions of soft-tissue sarcomas continue despite educational efforts.
- Orthopaedic surgeons contribute significantly to the burden of unplanned excisions, indicating a need for improved diagnostic and surgical pathways.
