title: Sarcomas in the groin and inguinal canal--often missed and difficult to manage.
abstract: BACKGROUND
  This is a 7-year retrospective review summarising the North of England Bone and Soft Tissue Tumour Service's experience of managing 13 cases of groin sarcoma requiring soft tissue flap reconstruction. This study was performed to try to identify where national referral guidelines in sarcoma management had been followed and reasons for any delays. The study also includes outcome data relating to these patients.
  
  
  METHODS
  A retrospective, case-note review was undertaken using the local sarcoma database to identify appropriate patients.
  
  
  RESULTS
  In nine patients, national referral guidelines were not followed. This resulted in a mean delay of presentation to the multidisciplinary team of 4.4 months. Ten patients had unplanned excision or exploration of tumours before referral. There were no lower limb amputations. All patients with narrow margins or high grade tumours were referred for radiotherapy. Four patients died; three as a result of distant metastases and one as a result of local recurrence.
  
  
  CONCLUSIONS
  Despite delays in referral, treatment by wide excision and plastic surgical reconstruction allowed for local control of these tumours with functional limb salvage. Implementation of National Institute for Health and Clinical Excellence (NICE) guidelines and local strategies could improve the expedient management of these patients.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK. tomcollin72@googlemail.com
authors.forename: T
authors.initials: T
authors.lastname: Collin
authors.forename: A V
authors.initials: AV
authors.lastname: Blackburn
authors.forename: R H
authors.initials: RH
authors.lastname: Milner
authors.forename: C
authors.initials: C
authors.lastname: Gerrand
authors.forename: M
authors.initials: M
authors.lastname: Ragbir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006119:Groin / Q000601:surgery*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D007264:Inguinal Canal / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D019651:Plastic Surgery Procedures / Q000379:methods; D012017:Referral and Consultation / Q000592:standards; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult