Enrico Martin

237 Abstract Background Malignant peripheral nerve sheath tumors (MPNST) are aggressive and possibly morbid sarcomas because of their origin in nerve tissue. However, postoperative functional status has had little attention in literature. The reconstruction of lost function after excision of any soft tissue sarcomas has also infrequently been described, but research does show that such reconstructions may be beneficial. This study investigated how surgical considerations and the use of functional reconstructions differed among surgeons treating MPNST. Methods Multiple national and international surgical societies were asked to distribute this survey amongst their members. Survey responses were analyzed overall and between surgical subspecialties (surgical oncology/neurosurgery/plastic surgery/other). Results A total of 30 surgical oncologists, 30 neurosurgeons, 85 plastic surgeons, and 29 ‘others’ filled out the survey. Surgical oncologists had the highest case load (p<0.001). Functional status was usually considered preoperatively among all subspecialties (65.1%); 42.2% never considered performing less extensive resections to preserve function. Neuropathic pain and motor deficits are seen in 40.9±22.9% and 36.7±25.5% respectively. Functional reconstructions for motor and sensory deficits were more commonly considered by plastic surgeons and ‘others’. Relative contraindications for reconstructions did not differ between subspecialties (p>0.05). Most surgeons would reconstruct directly or directly unless radiotherapy would be administered (62.7%). On average, surgeons would consider functional reconstructions when estimated survival is 3.0±2.0 years. Conclusion  Surgical treatment of MPNSTs differs slightly among subspecialties. Neuropathic pain, motor deficits, and sensory deficits are commonly acknowledged postoperative morbidities. Functional reconstructions are varyingly considered by surgeons. Surgical oncologists and neurosurgeons treat most patients, yet may be least likely to consider functional reconstructions. A multidisciplinary surgical and reconstructive approach may be beneficial in MPNSTs. 10