How Is the Spectrum of Sarcoma Surgery Assessed?

SIMPLE SUMMARY: Sarcoma surgery is the cornerstone of sarcoma therapy, which is organized highly multidisciplinarily. The critical determinant of tumor control depends on the experience of the multidisciplinary team (MDT), in which sarcoma surgery plays a pivotal part. In this study, an interoperable digital platform on sarcoma surgery was established to assess its spectrum based on a single sarcoma surgeon over one decade as a pilot. Being used at large scale, this platform may become an indispensable instrument to assess the contributions of sarcoma surgery within an MDT to tailor personalized patient quality care in the future. ABSTRACT: Purpose: To meet the challenges of the precision medicine era, quality assessment of shared sarcoma care becomes pivotal. The MDT approach is the most important parameter for a successful outcome. Of all MDT disciplines, surgery is the key step to rendering sarcoma patients disease free; therefore, defining its spectrum is critical. To the best of the authors’ knowledge, a comprehensive interoperable digital platform to assess the scope of sarcoma surgery in its full complexity is lacking. Methods: An interoperable digital platform on sarcoma surgery has been created to assess the clinical exposure, tumor characteristics, and surgical settings and techniques applied for both resections and reconstructions of sarcomas. Results: The surgical exposure of an individual surgeon over time served as a pilot. Over the study period of 10 years, there were 723 sarcoma board/MDT meetings discussing 3130 patients. A total of 1094 patients underwent 1250 surgical interventions on mesenchymal tumors by one single sarcoma surgeon. These included 615 deep soft tissue tumors (197 benign, 102 intermediate, 281 malignant, 27 simulator, 7 metastasis, 1 blood); 116 superficial soft tissue tumors (45 benign, 12 intermediate, 40 malignant, 18 simulator, 1 blood); and 519 bone tumors (129 benign, 112 intermediate, 182 malignant, 18 simulator, 46 metastasis, 14 blood, and 18 sequelae of first treatment). Detailed types of resections and reconstructions were analyzed. Conclusions: An interoperable digital data platform on sarcoma surgery with transparent real-time descriptive analytics is feasible and enables large-scale definition of the spectrum of sarcoma surgery to meet the challenges of sarcoma precision care in the future.