Refer prior to biopsy of suspected appendicular soft tissue sarcoma

N Z Med J. 2012 Nov 23;125(1366):12-9.

Abstract

Aim: Appendicular soft tissue tumours are rare and inappropriate investigation can result in unnecessary loss of limb or life. We reviewed the investigation and referrals of patients to our institution.

Method: This is a review of prospectively collected data stored in a tumour registry database. We included all patients (126) referred to the service for investigation and management with a primary soft tissue tumour in 2006 and 2007.

Results: There was a highly significant association (RR=6.2) between pre referral procedures (PRPs) and suffering a complication (P<0.0001) in comparison to non-biopsied referrals (NBRs). Those referred by general surgeons were more likely (RR=2.6) to have undergone PRP (p<0.0017). The median interval between referral and senior author review was 8 days for the PRP group and 10 days for the NBR group (P=0.2574).

Conclusion: Biopsy of suspected appendicular soft tissue sarcoma should be performed by a tumour specialist or in prior consultation with, to minimise adverse outcomes. There was minimal delay till review by an orthopaedic tumour specialist at Middlemore Hospital and achieving a tissue diagnosis does not expedite this.

MeSH terms

  • Aged
  • Amputation, Surgical
  • Biopsy / adverse effects
  • General Practice
  • General Surgery
  • Hemorrhage / etiology
  • Humans
  • Infections / etiology
  • Lower Extremity
  • Neoplasm, Residual
  • Orthopedics
  • Referral and Consultation*
  • Sarcoma / diagnosis
  • Sarcoma / pathology*
  • Sarcoma / surgery
  • Soft Tissue Neoplasms / diagnosis
  • Soft Tissue Neoplasms / pathology*
  • Soft Tissue Neoplasms / surgery
  • Tertiary Care Centers
  • Time Factors
  • Upper Extremity