Open Versus Core Needle Biopsy in Lower-Extremity Sarcoma: Current Practice Patterns and Patient Outcomes

Local Control in Soft Tissue Sarcomas

Soft tissue sarcoma is a rare heterogeneous group of tumors made up of over 100 histologic types and subtypes. Expert pathology review is crucial to confirm the correct diagnosis prior to treatment. Multidisciplinary discussion and management at an expert center is strongly recommended given the many nuances of treatment. Wide resection +/- preoperative radiotherapy is recommended in most extremity and trunk wall STS patients, while a minority may also require perioperative medical therapy. Macroscopic complete resection remains the standard of care for retroperitoneal sarcoma patients, with preoperative radiotherapy recommended in selected histologic types.

Proximal Humerus Reconstruction for Bone Sarcomas: A Critical Analysis

» The proximal humerus is a common location for primary bone tumors, and the goal of surgical care is to obtain a negative margin resection and subsequent reconstruction of the proximal humerus to allow for shoulder function.» The current evidence supports the use of reverse total shoulder arthroplasty over hemiarthroplasty when reconstructing the proximal humerus after resection of a bone sarcoma if the axillary nerve can be preserved.» There is a lack of high-quality data comparing allograft prosthetic composite (APC) with endoprosthetic reconstruction of the proximal humerus.» Reverse APC should be performed using an allograft with donor rotator cuff to allow for soft-tissue repair of the donor and host rotator cuff, leading to improvements in shoulder motion compared with an endoprosthesis.