What are the UK guidelines for assessment of soft tissue sarcoma (STS)?

Updated: Sep 02, 2018
  • Author: Steven C Katz, MD, FACS; Chief Editor: Edwin Choy, MD, PhD  more...
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Answer

Answer

Recommendations are as follows:

  • Any patient with a soft tissue mass that is increasing in size or is >5 cm, whether or not painful, should be referred either for an urgent ultrasound scan or directly to a sarcoma diagnostic center.
  • If the ultrasound scan does not definitively confirm benign pathology, the patient should be referred for further investigation on an urgent suspected cancer referral pathway.
  • Any retroperitoneal or intra-abdominal mass with an imaging appearance suggestive of an STS should be referred to a specialist center before biopsy or surgical treatment.
  • All patients with a suspected STS should be managed by a specialist sarcoma multidisciplinary team, as specified in the National Institute for Health and Clinical Excellence (NICE) guidance.
  • Ultrasound scan by a musculoskeletal radiologist should be considered as the first-line investigation and may be supplemented by ultrasound-guided core biopsy.
  • Magnetic resonance imaging and core needle biopsy are recommended prior to definitive surgery.
  • Imaging of the thorax by computed tomography scan for lung metastases should be done before radical treatment; further staging may be considered depending on subtype and location of the sarcoma.

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