Sarkomi Care pathway in sarcomas

klinična pot

Abstract

Izvleček

Za uspeh zdravljenja bolnikov s sarkomi je odločilnega pomena prvo zdravljenje, zato naj tumor ostane nedotaknjen. Ključna je napotitev bolnikov v referenčni center za sarkome, kjer naj potekata tako diagnostika kot zdravljenje. Prvo operacijo naj opravi sarkomski kirurg v referenčnem centru. Onkološki inštitut Ljubljana edini izpolnjuje pogoje za referenčni center za sarkome mehkih tkiv v Sloveniji. Ortopedska klinika Ljubljana je ob sodelovanju z Onkološkim inštitutom Ljubljana referenčni center za zdravljenje bolnikov s sarkomi kosti. Ob odsotni diagnozi rakave bolezni so za sarkom mehkih tkiv na trupu in udih sumljivi tumorji, ki hitro rastejo in/ali bolijo, vsi tumorji pod fascijo, ne glede na velikost in povrhnji tumorji, večji od 5 cm, v retroperitoneju pa tumorji, ki vsebujejo maščobo. Bolniki s tumorjem sumljivim za sarkom mehkih tkiv oziroma potrjenim sarkomom bodo imeli najboljše možnosti, če bodo napoteni na Onkološki inštitut v Ljubljano. V primeru radiološko ugotovljene lezije sumljive za primaren maligen tumor kosti pa, če bodo napoteni na Ortopedsko kliniko v Ljubljano.

Abstract (Eng)

Abstract

First treatment is crucial in the management of sarcoma patients, therefore it is essential to refer these patients to sarcoma centre. Diagnostic procedures and treatment have to proceed in sarcoma centre. First resection of the tumor has to be performed by a sarcoma surgeon. Institute of Oncology Ljubljana is the only referral centre for soft tissue sarcoma patients and Department of Orthopaedic surgery of the Ljubljana University Medical Centre is the only referral centre for bone sarcoma patients in Slovenia. In the absence of a diagnosis of malignant disease, rapidly growing and/or painfull tumors, all tumors deep to fascia and superficial tumors larger than 5 cm are suspicious for soft tissue sarcoma of the trunk and limbs; in retroperitoneum, tumors containing fat are suspicious for sarcoma. Patients with the tumor suspicious for soft tissue sarcoma or proven sarcoma schould be referred to the Institute of Oncology Ljubljana. Patients with the radiologic bone laesion suspicious for bone sarcoma schould be referred to the Department of Orthopaedic surgery of the Ljubljana University Medical Centre.