[Surgery for soft-tissue sarcomas of the limbs and trunk wall].
Soft-tissue sarcoma of the limbs or the trunk wall determine a heterogeneous group of tumours that tends to receive a more individualized approach. The surgeon in charge with soft-tissue sarcoma has to be familiar with these tumours in order to deliver an adequate treatment. Most important is the initial diagnostic procedure, comprising imaging with MRI, a core needle biopsy, and in France, referral to a centre of expertise within the clinical network NETSARC. Prior to surgery, a multidisciplinary conference determines its moment and the extent of surgical resection within the frame of a multidisciplinary approach, and also plans reconstructive surgery, when needed. A standardized operative report summarizes items necessary to describe the resection quality (i.e. tumour seen, tumour infiltrated?). In multidisciplinary staff meetings, they are compared to margins measured by the pathologist on the operative specimen. Hence, resection quality is determined collegially and defined by resection type R (R0, R1, R2) as a qualitative result. The quality of resection directly determines the 5-year risk of local recurrence, estimated between 10 and 20% in specialized centres, with the objective to attain 10%. Early rehabilitation favours better functional outcome. The surgeon's experience with soft-tissue sarcoma, as part of a multidisciplinary treatment, is key in achieving the best adequacy between oncological resection and favourable functional outcome. In France, a specific university course for soft-tissue sarcoma will be set-up.
Service de chirurgie, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France. Electronic address: e.stoeckle@bordeaux.unicancer.fr.
E
E
Stoeckle
Service de chirurgie, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
A
A
Michot
Service de radiothérapie, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
B
B
Henriques
Service de radiothérapie, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
P
P
Sargos
Service de chirurgie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
C
C
Honoré
Service de chirurgie, institut universitaire du cancer de Toulouse, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
G
G
Ferron
Service de chirurgie, centre Léon-Bérard, 28, rue Laënnec, 69373 Lyon cedex, France.
P
P
Meeus
Service d'anesthésie-réanimation, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux cedex, France.
F
F
Babre
Service de chirurgie, institut Curie, 26, rue d'Ulm, 75248 Paris, France.
S
S
Bonvalot
D001706:Biopsy; D005121:Extremities / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D000072662:Margins of Excision; D011182:Postoperative Care; D011300:Preoperative Care; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D060726:Torso / Q000601:surgery*
Chirurgie; Clinical network; Functional outcome; Qualité de résection; Resection quality; Réseau clinique; Résultats fonctionnels; Sarcome des tissus mous; Soft-tissue sarcoma; Surgery