(P 228) FREQUENCY AND CLARITY OF SURGICAL GOALS FOR TUMOR RESECTION IN ADVANCED SARCOMA

Objective: Tumor resection in advanced sarcoma is often non-curative, but may prolong life, preserve function, and provide palliation. Clearly stating how surgery may help patients live longer and/or improve their quality of life is essential in supporting informed decision-making, yet the frequency of this documentation is unknown. This study aimed to determine how often tumor resection is performed for advanced sarcoma and evaluate whether surgical goals were documented in preoperative clinic notes.

Methods: A retrospective cohort study was conducted among patients ≥18 years old who underwent tumor resection for any site of soft tissue sarcoma from March 2024 to February 2025 at two academic medical centers. Advanced sarcoma was defined as recurrent or metastatic disease. Preoperative notes were abstracted, categorizing patient-centered surgical goals to prolong life, relieve symptoms, prevent disability, or obtain diagnosis.

Results: Of 291 patients who had tumor resection for sarcoma, 102 (35.1%) had advanced disease (Table). Among these, 31 (30.4%) had a documented patient-centered surgical goal. An additional 27 (26.5%) referenced goals for cancer control, albeit without identifying a clear patient benefit. In 44 (43.1%) tumor resections for advanced sarcoma, no surgical goal was documented.

Conclusion: In this multisite cohort study, over one-third of sarcoma surgeries were for advanced disease, yet patient-centered surgical goals were documented in only 30% of these cases. Communicating and documenting how surgery aligns with patients' goals can better counsel patients as they consider the value of surgery for advanced sarcoma.

Histologic Subtypes and Preoperative Documentation of Surgical Goals in Patients Undergoing Tumor Resection for Advanced Sarcoma