Principles of Surgical Treatment of Soft Tissue Sarcomas
Simple Summary
Abstract
1. Introduction
2. Preoperative Workup and Treatment
2.1. Importance of Preoperative Evaluation in STS
2.2. Imaging Modalities for Primary Tumor Assessment
2.3. Disease Staging
2.4. Preoperative Biopsy
2.5. Radiation Therapy
2.6. Chemotherapy
2.7. Alternative and Augmentative Treatment Approaches
3. Surgical Treatment
3.1. Margin Assessment
3.2. Limb Salvage Versus Amputation
3.3. Additional Surgical Consideration
3.3.1. Periosteal Stripping
3.3.2. Nerve Resection
3.3.3. Vascular Resection
3.3.4. Soft Tissue Closure
4. Postoperative Period
Postoperative Surveillance
5. Complex Situations in STS Management
5.1. Previous Unplanned Excision
5.2. Microscopically Invasive Tumors
5.3. Tumor Recurrence
- a.
- Local recurrence
- b.
- Distant recurrence
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Recommendations | Strength of Recommendation | |
---|---|---|
1 | For patients with primary, localized extremity and truncal soft-tissue sarcoma (STS) for whom oncologic resection is planned, RT is recommended for those at increased risk for local recurrence. | Strong |
2 | For patients with primary, localized extremity and truncal STS for whom oncologic resection is planned and a close or microscopically positive margin is anticipated, RT is recommended. | Strong |
3 | For patients with primary, localized extremity and truncal STS for whom oncologic resection is planned, RT is not recommended for those at low risk for local recurrence. | Strong |
Recommendations | Strength of Recommendation | ||
---|---|---|---|
1 | For patients with primary, localized extremity and truncal STS, the sequencing of surgery and RT should be determined based on multidisciplinary evaluation of patient and tumor characteristics. | Strong | |
2 | Preoperative RT | For patients with primary, localized extremity and truncal STS, where surgery and RT are indicated, preoperative RT is recommended over postoperative RT. | Strong |
3 | Postoperative RT | For patients with primary, localized extremity and truncal STS treated with initial oncologic resection (without preoperative RT) found to have unanticipated adverse pathologic features, postoperative RT is recommended. | Strong |
4 | For patients with primary, localized extremity and truncal STS, where surgery and RT are indicated, initial oncologic resection followed by postoperative RT is conditionally recommended in specific clinical circumstances (e.g., uncontrolled pain or bleeding, fungating tumors), or when the risk of wound healing complications outweighs that of late toxicity. | Conditional |
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Gonzalez, M.R.; Mendez-Guerra, C.; Goh, M.H.; Pretell-Mazzini, J. Principles of Surgical Treatment of Soft Tissue Sarcomas. Cancers 2025, 17, 401. https://doi.org/10.3390/cancers17030401
Gonzalez MR, Mendez-Guerra C, Goh MH, Pretell-Mazzini J. Principles of Surgical Treatment of Soft Tissue Sarcomas. Cancers. 2025; 17(3):401. https://doi.org/10.3390/cancers17030401
Chicago/Turabian StyleGonzalez, Marcos R., Carolina Mendez-Guerra, Megan H. Goh, and Juan Pretell-Mazzini. 2025. "Principles of Surgical Treatment of Soft Tissue Sarcomas" Cancers 17, no. 3: 401. https://doi.org/10.3390/cancers17030401
APA StyleGonzalez, M. R., Mendez-Guerra, C., Goh, M. H., & Pretell-Mazzini, J. (2025). Principles of Surgical Treatment of Soft Tissue Sarcomas. Cancers, 17(3), 401. https://doi.org/10.3390/cancers17030401