Surgery for Sarcoma in Children

The type of surgery your child receives depends on the type of sarcoma he or she has and the tumor’s size and location. Surgery typically follows chemotherapy to shrink the tumor, possibly making it easier to remove. Some sarcomas, however, may be removed before chemotherapy. In some situations, radiation therapy is used before or after surgery to help shrink a tumor.

Surgery is also used when cancer has spread to the lungs or other parts of the body. The type of surgery used depends on the location and size of the tumor or tumors. 

Surgery for Bone Tumors

The goal of surgery is to remove the tumor while limiting damage to the surrounding bone, tissue, and other structures, such as muscles and tendons. 

Limb-Sparing Surgery

Thanks to advances in treatments for bone sarcomas, most of the time an arm or a leg is preserved during surgery. Such limb-sparing surgery is a very complex procedure; the tumor must be removed with minimal damage to the surrounding blood vessels, nerves, and tendons. 

During the surgery, the orthopedic surgeon removes the affected section of bone and replaces it with a bone graft, a piece of bone from another area of a child’s body. Or the surgeon may use a prosthesis, a metal or plastic device shaped like the bone. The surgeon may be able to use a special prosthesis that can be expanded through minor surgical procedures as your child grows. For a young child, the prosthesis may be surgically replaced by a larger one when he or she gets older and bigger.

Amputation

When a tumor is large, or when it wraps around blood vessels, nerves, or tendons, part or all of an arm or leg may be surgically removed. Sometimes, amputation is necessary if a large tumor surrounds nerves or blood vessels. After surgery, your child is fitted with a prosthetic limb.

Surgery for Soft Tissue Tumors

Surgery is frequently used to remove sarcomas that originate in the head and neck, chest wall, or pelvis. The goal of the surgery is to remove the tumor along with a margin of surrounding tissue. Your child’s surgeon decides whether the tumor can be removed safely and without causing long-term consequences, such as disfigurement or the loss of an organ. Our doctors are careful to avoid cutting blood vessels, nerves, and tendons. 

Chemotherapy or radiation therapy may be used prior to surgery to shrink tumors to more manageable sizes. A second surgery may be required if a tumor cannot be completely removed.

Reconstructive Surgery

Sometimes, surgery to remove a tumor causes a disfigurement requiring reconstructive surgery. In these situations, plastic surgery can help your child look and function as naturally as possible. With reconstructive surgery, a plastic surgeon may remove bone, fat, muscle, skin, or other tissue from another part of the body and surgically attach it to the space left by the tumor. This surgery can often be done at the same time the doctor removes the tumor. 

For surgeries that affect larger areas of the body, tissue flaps may be used. These are pieces of tissue that are attached to the body by a vein. The flap is removed and transplanted to the tumor site, and its blood vessels are reattached.

Rehabilitation after Sarcoma Surgery

Many types of sarcoma surgeries can affect a child’s movement and functioning, so rehabilitation may be needed. The Stephen D. Hassenfeld Children’s Center for Cancer and Blood Disorders, part of Hassenfeld Children's Hospital of New York, offers pediatric rehabilitation services in conjunction with NYU Langone’s Rusk Rehabilitation. Physical and occupational therapists can help your child build strength, endurance, and mobility and improve his or her range of motion after treatment.

Doctors who specialize in rehabilitation medicine, called physiatrists, plus psychologists, nurses, social workers, and child-life specialists, work as a team to improve your child’s physical wellbeing.

Our specialists encourage children and their families to be part of the treatment team during rehabilitation.

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