• Vol. 44 No. 10, 474–483
  • 15 October 2015

Singapore Cancer Network (SCAN) Guidelines for the Initial Evaluation, Diagnosis, and Management of Extremity Soft Tissue Sarcoma and Osteosarcoma

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ABSTRACT

Introduction: The SCAN sarcoma workgroup aimed to develop Singapore Cancer Network (SCAN) clinical practice guidelines for the initial evaluation, diagnosis, and management of extremity soft tissue sarcoma and osteosarcoma.

Materials and Methods: The workgroup utilised a modified ADAPTE process to calibrate high quality international evidence-based clinical practice guidelines to our local setting.

Results: : Various international guidelines from the fields of radiology, pathology, orthopaedic surgery, medical, radiation and paediatric oncology were reviewed, including those developed by von Mehren M et al (J Natl Compr Canc Netw 2014), the National Collaborating Centre for Cancer (2006), the European Sarcoma Network Working Group (2012) and Grimer RJ et al (Sarcoma 2008). Our clinical practice guidelines contextualised to the local patient will streamline care and improve clinical outcomes for patients with extremity soft tissue and osteosarcoma.

Conclusion: These guidelines form the SCAN Guidelines 2015 for the initial evaluation, diagnosis, and management of extremity soft tissue sarcoma and osteosarcoma.


Sarcoma is an uncommon and heterogeneous family of cancers, with more than 50 clinico-pathologically distinct subtypes representing 1% of all malignancies. Although ubiquitous in presentation, a significant proportion arises from the extremities. Data from our large sarcoma database which comprise 1029 unique patients demonstrates that 35% of all sarcomas arise from the extremities with soft tissue sarcomas (STS) accounting for 87% of these cases. The 3 most common STS histotypes include liposarcoma, unclassified pleomorphic sarcoma (UPS) formerly termed malignant fibrous histiocytoma (MFH), and myxofibrosarcoma. In the remaining 13% of extremity bone sarcomas, osteosarcomas account for half of the cases.

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