Multidisciplinary team approach in the management of sarcoma patients: impact on treatment outcomes

Abstract

Objectives. Sarcomas are rare, complex tumors originating from mesenchymal tissues, known for their histological diversity and challenging clinical presentations. Their management requires a multidisciplinary approach due to the complexity of diagnosis and treatment. Multidisciplinary team (MDT) consultations integrate expertise from various specialists to optimize treatment strategies. This study aimed to evaluate the demographics, clinical characteristics, and outcomes of sarcoma patients, focusing on the impact of MDT consultations on surgical radicality, preoperative planning, and overall care quality. Materials and methods. This retrospective study analyzed 67 sarcoma cases diagnosed between May 22, 2022, and October 30, 2023, at Kaunas Clinics, Ocology and Hematology Department. Statistical analysis was performed using IBM SPSS Statistics version 29.0.2.0. Results. The study included 67 patients, 44.8% female (n=30) and 55.2% male (n=37), with a mean age of 58 years (range 10–92). Most patients (79.1%, n=53) presented with primary tumors. Tumors were most commonly located in the extremities (54.5%, n=36) and retroperitoneum (22.7%, n=15). Soft tissue sarcomas were the most frequent (43.3%, n=29). Surgical treatment was performed on 56 patients; 25 had no prior biopsy, and 9 lacked preoperative imaging. Among 11 recurrence cases, 8 had incomplete resections (R1/R2) without MDT consultation. Recurrence rates were significantly associated with surgical radicality (p=0.004). MDT involvement reduced incomplete resections from 60% to 26%. MDT consultations occurred in 76.1% of cases, mostly for surgical planning (28.4%, n=19). Neoadjuvant therapy guided by MDTs was used in 13.4% of cases. Four patients died due to advanced disease. Conclusions. MDT consultations significantly improve sarcoma management by enhancing surgical outcomes and reducing incomplete resections. Neoadjuvant therapy guided by MDTs contributes to better preoperative planning, emphasizing the value of multidisciplinary collaboration in optimizing treatment and patient outcomes.