Soft tissue sarcoma management in association with an oncologist and allied surgical disciplines

The mainstay of management of soft tissue sarcoma remains surgical excision. The use of radiotherapy has mainly an adjuvant role. Staging of the tumour is crucial for the management. Low grade sarcoma removed with a clear wide margin can be treated alone by surgery. Higher grade tumours or resections that have close or positive margins will need in addition radiotherapy.

The radiotherapy may be given either preoperatively. Chemotherapy may be used in concert with radiotherapy to initially treat large or irresectable yet localized tumours. The aim is to palliate, shrink or render them resectable for best form of local control. In the present form of available treatment the need for amputation rarely arises. But for advanced tumours especially in the absence of metastatic disease this will give the patient possibility of cure.

When resection by wide local excision is to be performed invariably vital functional anatomical elements have to be sacrificed. Reconstructive surgery is then responsible for restoring or preserving function and providing adequate soft tissue cover. In the absence of plastic and reconstructive expertise the tumour maybe falsely labeled as irresectable. A team approach to managing this condition is very important.