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PDS pathway in the UK

Thank you for completing this survey on the pathway for patients with pleomorphic dermal sarcoma (PDS). Please answer all the questions and please give an opinion even if that part of the pathway is not part of your role. We are grateful for your help, and will use this information gathered here to make recommendations on a standard of care for these cases. 

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* 1. What is your speciality

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* 2. In what role are you answering this survey?  If you attend more than one MDT, choose the one where you see most cases of PDS annually, and continue this survey with relation to that MDT.

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* 3. Please state the NHS region in which your MDT is based

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* 4. How many Pleomorphic Dermal Sarcoma cases are discusssed at this MDT annually

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* 5. At which of the following points in the pathway is a PDS discussed in your region/your MDT? Tick all which apply

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* 6. How frequently is there a MDT outcome which includes to request further/any immunohistochemistry (IHC) in a case of suspected PDS in your region?

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* 7. What in your opinion is the correct first procedure in the following scenario? A  2.1 cm clinical diameter clinically malignant exophytic lesion  on the scalp, mobile over pericranium. Healthy immunocompetent patient, Clinically N0. 

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* 8. If you answered Non-excisional biopsy to previous question, which of the options would you carry out/recommend? Choose one or more

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* 9. Which of the following would the usual next step be in your region with the same parameters as question 6?  A biopsy has confirmed PDS and the main part of the lesion is still present. (Discussion at the sarcoma MDT assumes a second histology opinion)

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* 10. Which of the following would the usual next step be in your region with the same parameters as question 6?  A attempted curative excision biopsy has confirmed PDS, there was a close deep margin on histology ( 0.2mm), pericranium was preserved and there is a healed full thickness graft in place.

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* 11. In cases of histologically proven non metastatic PDS, do you usually refer to the sarcoma MDT? 

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* 12. Please comment on the following statements.  (This should be your view where there are no other patient factors involved which could influence the pathway on an individual basis.)

  Strongly agree Agree Neutral Disagree Strongly disagree
Local operable disease - All PDS cases should have a sarcoma MDT remote opinion
Local operable disease- All PDS patients should be seen in person by the sarcoma MDT
Local operable disease - All PDS patients should have treatment from their local non-sarcoma MDT
Local operable disease - All PDS patients should have any recommended surgical treatment delivered by the sarcoma MDT
Local  disease- All PDS patients should have any recommended radiotherapy treatment to the primary site delivered by the sarcoma MDT

All PDS patients should have any recommended radiotherapy treatment to metastatic disease delivered by the sarcoma MDT
All PDS patients should have any recommended SACT ( systemic anti-cancer treatment) treatment delivered by the sarcoma MDT

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* 13. Which of the following reasons influenced your choices in question 11? Tick all which apply

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* 14. What do you consider to be appropriate staging investigations in the 2.1cm mobile on pericranium biopsy proven PDS scalp case described,  N0M0 clinically   '

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* 15. What do you consider the correct surgical clinical resection margin in a biopsy proven 2.1cm diameter scalp PDS, N0 M0, mobile on pericranium to be PERIPHERALLY

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* 16. What do you consider the correct surgical clinical resection margin in a biopsy proven 2.1cm diameter scalp PDS, N0 M0, mobile on pericranium to be DEEPLY?  ( ie what is the deepest layer one should include in a resection with curative intent)

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* 17. What do you consider to be a clear histological margin in a 2.1cm diameter PDS surgical excision, ie no further surgery or adjuvant RT would be recommended by your MDT?

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* 18. Where resection with clear margins has been achieved of this 2.1cm PDS (N0 M0), by whom in your opinion should surveillance follow up usually be carried out?

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* 19. How frequently in your opinion should a patient with a 2.1cm completely resected scalp PDS (N0 M0) be followed up  in the first 2 post op years

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* 20. How frequently should a review take place years 2-5

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* 21. Would you review beyond 5 years?

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* 22. What do you consider to be appropriate surveillance imaging  investigations in the 2.1cm scalp PDS described,  N0M0. Treatment has been excision with curative intent and resection is histologically complete.

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* 23. If offering imaging surveillance for the case described, how frequently would you offer this, and for how long? Please answer N/A if you would not offer surveillance.

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* 24. Do you have any further comment re where care for a patient with smaller i.e. 1cm  N0 M0 PDS should be delivered? please state no if none

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* 25. Which MDT should USUALLY deliver care of  a patient with metastatic PDS ?

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* 26. Do you have any other comment ? Please state no if  none

0 of 26 answered
 

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