Enrico Martin

243 Current attitudes towards function preservation surgeons regard as eligible for MPNST patients differed between subspecialties (all p<0.05, Figure 5 ). Plastic surgeons most commonly considered nerve reconstructions, nerve transfers, tendon transfers, and free functioning muscle transfers (FFMT) to be possibilities to reconstruct function in MPNST patients (all >80%). Neurosurgeons and surgical oncologists were both most likely to answer that they do not know, and most commonly considered options ineligible. Relative contraindications for functional reconstructions in MPNST patients with a functional deficit did not differ between subspecialties (p>0.05). Most contraindications were only checked by less than a third of all respondents. Overall, 20.5% of respondents did not deem slow rehabilitation after reconstruction, slow nerve regeneration, the use of radiotherapy, a non-extremity tumor site, the general poor prognosis of MPNST patients, or the nerve of origin as a ‘sick’ nerve relative contraindications for functional reconstructions in MPNST patients. Responses did not differ significantly between subspecialties except for general low survival of MPNST patients (p<0.05). Neurosurgeons (70.6%) and plastic surgeons (40.7%) most commonly considered the latter a reason to not reconstruct lost function. All surgeons agreed that on average, a patient needs to have a life expectancy of at least 3.0 ± 2.0 years to be considered eligible for reconstruction. (p>0.05, Figure 4C ). Overall, p=0.413 0% 25% 50% 75% 100% Surgical Oncology Neurosurgery Plastic Surgery Other Specialties Neuropathic pain Motor disability Sensory deficiency Combination None Observed postoperative morbidities A Overall p=0.275 0% 25% 50% 75% 100% Surgical Oncology Neurosurgery Plastic Surgery Other Specialties No Sometimes No free margin Perform less extensive resections B Overall, p=0.099 0% 25% 50% 75% 100% Surgical Oncology Neurosurgery Plastic Surgery Other Specialties Percentage postoperative motor deficits C Overall p=0.824 0% 25% 50% 75% 100% Surgical Oncology Neurosurgery Plastic Surgery Other Specialties Percentage postoperative neuropathic pain D Figure 3: Complications after MPNST resections. A) Most common postoperative complication per subspecialty B) Considering resecting less tumor per subspecialty C) Mean postoperative prevalence of motor deficits per subspecialty D) Mean postoperative prevalence of neuropathic pain per subspecialty. 10