Types of sarcoma surgery by area
Taking sarcomas out in one piece (known as en bloc removal or wide resection) provides the best outcome. Our surgeons perform en bloc surgery whenever possible, taking a little extra healthy tissue beyond the edges of the tumor. Following these steps greatly reduces the chance that cancer will return in the same location.
The additional surgical approaches we take depends on the location of the tumor:
Our team of orthopaedic oncologists and reconstructive surgeons is able to save limbs about 90 percent of the time, effectively removing tumors in the arms and legs while preserving function and appearance. We achieve this result even with complex and large sarcomas, which is not the case at all healthcare institutions when it comes to sarcoma surgery.
We also work to provide you with full limb function upon recovery, without pain. Ideally, we want to get you back to the function and mobility you had before your cancer diagnosis.
While our preference is always to spare limbs, there are times when we recommend amputation in order to remove the sarcoma completely, to preserve critical structures, or more effectively treat the cancer. In such cases, we will help you prepare for what to expect and provide full support to help you recover and adapt as quickly as possible.
Sarcoma removal in the retroperitoneum (the space in the back of the belly) is often complex. Surgeries frequently involve the colon, kidneys, spleen, or pancreas.
Our surgical oncologists partner with orthopaedic oncologists, neurosurgeons, vascular surgeons, and plastic surgeons for team surgeries as needed. Our team protects blood vessels and tries to preserve organ function as much as possible. If surgeries do involve the organs, we work to minimize the impact on your daily life and support your recovery.
Head and neck surgeons often perform TransOral Robotic Surgery (TORS) to remove sarcomas. They work to minimize the potential impact of the operation on speaking, chewing, and swallowing. If you do experience side effects, we coordinate care with dietitians and speech and language therapists.
The spine contains sensitive nerves that control body parts such as the arms, legs, bladder, and bowels. Removing tumors in the spine and skull base (bottom of the skull) in one piece requires particular skill and expertise.
Operating in these complex locations involves careful planning and teamwork. Our team plans surgeries using 3D visualization. We also discuss possible impacts on function with you before proceeding. Depending on the location of your tumor, you may be cared for by a neurosurgeon as well as other specialized surgeons who will repair nerves or transfer them from other parts of the body or from donors. Physical therapists and orthotists can provide additional services for rehabilitation after surgery.
Our neurosurgeons typically use minimally invasive approaches to reduce the risk of complications. For upper spine and skull base sarcomas, they may use TORS, which allows them to access areas that are difficult to reach. When appropriate, they use GPS-like navigation during operations to make precise cuts.
If you are diagnosed with a uterine sarcoma, our team usually recommends a total hysterectomy (removal of the uterus and cervix) as part of treatment. An experienced Penn Medicine gynecologic oncologist performs the operation and oversees your care. We take careful steps to keep incisions small, while still keeping the cancer from contaminating other areas.
We may also recommend removing the ovaries and fallopian tubes in certain cases.
Removing tumors in the pelvis is complex, particularly if surgeons need to take out both soft tissue and bone. Our surgeons do their best to preserve mobility, using minimally invasive procedures such as laparoscopy or robotic-assisted surgery when appropriate.