Adult Soft-Tissue Sarcomas of the Extremities

J Bone Joint Surg Am. 2022 Feb 16;104(4):379-389. doi: 10.2106/JBJS.21.00196.

Abstract

➤: Soft-tissue sarcomas (STS) in adults comprise a heterogeneous group of tumors of mesenchymal origin that share similar biological patterns of local tumor growth and metastatic dissemination.

➤: The judicious use of imaging studies, biopsy techniques, and pathological evaluations is essential for accurate diagnosis and for planning treatment strategy.

➤: Wide local resection and radiation therapy form the cornerstone of management of high-grade STS. The role of adjuvant radiation therapy is questionable in the management of small (≤5 cm) superficial lesions that can be resected with negative margins. Chemotherapy given to patients who have nonmetastatic, high-grade STS results in varying benefit in terms of local tumor control and overall survival.

➤: Coordinated care by a multidisciplinary team of trained surgeons, medical oncologists, radiologists, radiation oncologists, and pathologists has been documented to improve local tumor control and the overall survival of patients with STS.

➤: Although considerable progress in tumor diagnostics and targeted therapies has been made over the past 2 decades, recommendations and controversies relating to tumor imaging and margins of resection have not changed.

Publication types

  • Review

MeSH terms

  • Chemotherapy, Adjuvant
  • Extremities / pathology
  • Extremities / surgery*
  • Humans
  • Radiotherapy, Adjuvant
  • Sarcoma / drug therapy
  • Sarcoma / pathology
  • Sarcoma / radiotherapy
  • Sarcoma / surgery*
  • Soft Tissue Neoplasms / drug therapy
  • Soft Tissue Neoplasms / pathology
  • Soft Tissue Neoplasms / radiotherapy
  • Soft Tissue Neoplasms / surgery*