UAB Musculoskeletal Sarcoma Surgery Program

By Herrick Siegel, MD

UAB Musculoskeletal Sarcoma Surgery Program

X Ray of heel replacement that was done eight years ago shows good long term functional results.

The UAB Sarcoma Surgery Section is a nationally recognized center for surgical treatment and reconstructions.

Although sarcoma comprises only about one percent of all adult cancers, it is relatively prevalent in children where it makes up approximately 20 percent of all childhood cancers. It is composed of many subtypes because it can arise from a variety of tissue structures, including nerves, muscles, joints, bone, fat, and blood vessels, which are collectively referred to as the body's connective tissues. Because these tissues are found everywhere on the body, sarcomas can arise anywhere. As a result, within each site of the more common cancers, there is the occasional surprise sarcoma diagnosis.

The most frequent location are the limbs since this is where the majority of the body's connective tissue resides. They are commonly hidden deep in the body, so sarcoma is often diagnosed when it has already become too large to expect a hope of being cured. Although a lot of the lumps phsycians see are benign, people should have them looked at by a doctor at an early stage in case it is sarcoma.

Since joining UAB in 2002, following a fellowship in orthopaedic oncology, I have found our institution to be at the forefront of novel techniques to restore patients' function so that they can resume a good quality of life as soon as possible. UAB has allowed our surgeons access to the newest orthopaedic implants and treatment. We work closely with our medical and radiation oncology partners to facilitate a team approach with each patient. UAB orthopaedic oncology also works with other cancer centers in our community such as St Vincent's, Brookwood and Grandview, which has been rewarding. UAB serves a large regional referral area from the gulf coast of Florida to southern Tennessee and from central Georgia to Jackson, Mississippi.

Biopsies are often performed by musculoskeletal radiologists with special training in biopsy techniques. We recommend that the definitive treating surgeon be involved with the biopsy technique and placement to avoid unnecessary tumor seeding. Radiation oncology and a medical oncologist with specialized training are involved with adjuvant treatment that will help the surgeon maximize limb salvage potential and reduce the potential for recurrence of the tumor.

Sarcoma is curable by surgery about 20 percent of the time, or by surgery with chemotherapy and/or radiation another 50 to 55 percent of the time, but about half the time they are totally resistant to all of these approaches, thus the extreme need for new therapeutic approaches. At any one time, over 50,000 patients and their families are struggling with sarcoma. More than 16,000 new cases are diagnosed each year and nearly 7,000 people die each year from sarcoma in the United States.

The sarcoma group's first priority is killing the tumor and it is than up to us reconstructive surgeons to optimize function and quality of life. It is a team approach, from diagnosis to final clinical result. At UAB, other surgical subspecialties are also involved with the care of many of the patients including vascular, surgical oncology, and plastic surgery.

For more information about tumors of the extremities or pelvis, please contact UAB Orthopaedic Oncology at 205 930 8339.