Enrico Martin

93 Oncological treatment considerations Table 1 Demographical data of survey participants Variable Oncologic Surgery Neuro- surgery Plastic Surgery Other Specialties P Number of participants 30 30 85 29 Experience Mean (SD) 15.64 (9.31) 13.26 (8.64) 13.49 (9.81) 15.64 (10.13) 0.603 <10 Years 28.6% 37.0% 43.1% 36.0% 0.585 10-20 Years 50.0% 37.0% 34.7% 28.0% >20 Years 21.4% 25.9% 22.2% 36.0% Fellowship training Sarcoma 81.5% 0.0% 2.8% 8.0% <0.001 PNS 0.0% 55.6% 29.2% 56.0% Sarcoma & PNS 3.7% 0.0% 2.8% 0.0% Other or none 14.8% 44.4% 65.3% 36.0% Annual caseload 0-1 18.5% 50.0% 70.4% 66.7% <0.001 2-3 22.2% 34.6% 22.5% 12.5% 3-5 33.3% 15.4% 2.8% 12.5% >5 25.9% 0.0% 4.2% 8.3% Tumor sites operated Intracranial 0.0% 34.6% 0.0% 0.0% <0.001 Head & neck 18.5% 42.3% 14.1% 8.3% 0.007 (Para)spinal 22.2% 76.9% 1.4% 4.2% <0.001 Superficial thoracic 55.6% 34.6% 8.5% 8.3% <0.001 Intrathoracic 37.0% 15.4% 0.0% 0.0% <0.001 Abdominal 74.1% 23.1% 5.6% 4.2% <0.001 Retroperitoneal 74.1% 46.2% 4.2% 0.0% <0.001 Pelvic 81.5% 38.5% 1.4% 8.3% <0.001 Extremities 85.2% 84.6% 93.0% 75.0% 0.136 Brachial plexus 37.0% 65.4% 35.2% 41.7% 0.059 PNS: peripheral nerve surgery, SD: standard deviation Surgical treatment and postoperative morbidity On average, 53% of all respondents always consider preservation of function before performing a resection; most commonly plastic surgeons did so (66%, p>0.05, Figure 3 ). Less than 8% would consider preservation of function given particular circumstances: based on localization (n = 3), in low-grade MPNSTs (n = 1), in case it does not interfere with oncological resection (n = 1), when multiple lesions are present (n = 1), or if a main nerve bundle is separable from the tumor (n = 1). Contrarily, 42% of all surgeons would never perform less extensive resections to preserve functionality and possibly compromise oncological result, and this did not differ between surgical subspecialties (p>0.05). Others would only resect less if achieving free margins was not presumed feasible (36%), while a minority would consider it in other cases as well (22%). The majority of respondents always look for the nerve of origin peroperatively (74%). In the hypothetical situation of a microscopically complete resectable MPNST, 47% of respondents had the opinion that there is a beneficial effect of resecting more of the originating nerve to decrease local recurrence as microscopic satellite lesions within or along the nerve may be present. 5