Frequency and clarity of surgical goals for tumor resection in advanced soft tissue sarcoma

<h2>ABSTRACT</h2> Surgery for advanced soft tissue sarcoma patients is often non-curative but may offer palliative benefits. Clearly stating how surgery may help patients live longer and/or improve their quality of life is essential to support informed decision-making. However, the frequency of documentation of surgical goals in medical records is unknown. We conducted a retrospective cohort study 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 soft tissue sarcoma was defined as recurrent or metastatic disease. Preoperative notes were abstracted and categorized based on patient-centered surgical goals, which included prolonging life, relieving symptoms, preserving function, and diagnosing disease. Among 291 patients, 103 (35.5%) had advanced disease, only 31 of whom (30.1%) had a documented patient-centered surgical goal. Records for an additional 27 (26.2%) referenced cancer control without a clear patient-centered benefit, and 45 (43.7%) had no goal documented. These findings suggest the need to improve documentation of surgical goals for advanced sarcoma.