Enrico Martin

92 Chapter 5 70% 23% 4% 2% 1% 1% Count (n) 25 50 75 100 Figure 1 World map showing the geographical distribution of survey respondents per continent. The surface of the bubbles corresponds to the number of respondents. Preoperative diagnostics Opinions regarding preoperative work-up of soft tissue tumors that may originate from peripheral nerves differs between surgical subspecialties ( Figure 2 ). The majority of respondents would perform radiological imaging and a biopsy before operating (65%), and surgical oncologists strongly agreed on this (92%, p<0.05). Regarding preoperative imaging studies, surgeons agreed that an MRI is necessary (95%, p>0.05). FDG-PET scans which can be used both for staging and possible differentiation of benign and malignant lesions are more commonly performed by neurosurgeons (67%) and surgical oncologists (48%, p<0.05). Preoperative staging was carried out by 44% of respondents, most commonly by surgical oncologists (80%, p<0.001). A CT-thorax is used by 25%, of which more than half would be in conjunction with an FDG-PET scan. A total of 10% would also carry out other radiologic diagnostics preoperatively. Preferred type of biopsy differed significantly between the surgical subspecialties (p<0.001). Overall, core needle biopsy was the preferred type of biopsy, especially among surgical oncologists (96%). Plastic surgeons and ‘other’ surgeons commonly also preferred open biopsies. Plastic surgeons were also most likely not to have a preferred biopsy technique (17%). Respondents that did not regard a preoperative biopsy necessary commonly reported that they considered the chances of tumor spread too high and would therefore directly proceed to surgery.