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Aims The rarity of thoracic sarcomas leads to challenges in their diagnosis and evidence-based management. We aim to investigate the management and outcomes of primary thoracic sarcoma patients under the care of our tertiary centre Sarcoma Service over a three-year period. Methods Data of all thoracic sarcoma patients discussed at the tertiary centre multidisciplinary meetings from 2017–2019 were collected from the local electronic database. Results 65 patients met the inclusion criteria. The most common histological subtypes were chondrosarcomas and spindle cell sarcomas. 60% of cases were high-grade sarcomas. 14 out of 19 deaths occurred in patients with high grade sarcomas (p=0.0586). 78.3% of patients underwent surgical resection, with 35.4% undergoing surgical resection as their sole treatment modality. Surgical intervention was associated with a statistically significant improvement in survival (p < 0.0001*). Clear marginal status was associated with better survival outcomes (p = 0.026*). Local recurrence was seen in 15 cases, and 93.3% of these were in high-grade sarcomas. There was no association between recurrence and marginal status. 8 of the 15 cases with recurrence received surgical intervention for the recurrence. 4 of the cases with recurrence passed away within the study time frame. Conclusion Primary resection should remain the gold standard for treatment of thoracic sarcomas due to its significant improvement in survival. Variability between outcomes and overall survival is likely multifactorial – diversity of histological subtypes, predominance of high-grade sarcomas, and a wide range of age at diagnosis. Prospectively maintained databases and cross-centre collaboration would be beneficial for future study in thoracic sarcomas.

The section on changes in training from the Future in Surgery Report by the Royal College of Surgeons of England outlined key ideas for improving surgical training in the future. These ideas included the use of augmented reality, virtual reality and simulation, as well as increased support for surgeons to diverge from traditional surgical training pathways to undertake research and act as entrepreneurs. The Second Oxford Surgical Innovation Conference (OxSI) had similar aims to prepare delegates for these changes in surgery. The event took place on Friday 13th March 2020 at St Catherine's College, Oxford, and included talks and workshops from world-renowned surgeons, which covered a vast range of topics but ultimately all gave a fascinating insight into what is needed to improve surgical practice and policy.