How I treat localized soft tissue sarcomas: update on diagnosis, risk-stratification and treatment

Anticancer Section / Original Paper

Mazzocca A. · Paternostro F. · Minelli A. · Silletta M. · Greco C. · Valeri S. · Ramella S. · Tonini G. · Vincenzi B.

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Article / Publication Details Abstract

Background: Adult-type soft tissue sarcomas (STS) are rare tumors representing about 1% of all adult malignant tumors. Their extreme histological heterogeneity places them among the most challenging fields of diagnostic pathology. The variability of clinical and prognostic presentation between the various histotypes reflects the different management that should be followed on a case-by-case basis. These features make soft tissue sarcomas the case in point of how important it is a centralized and multidisciplinary approach. Summary: Surgery represents the mainstay in the treatment of localized soft tissue sarcomas. Recently, more and more studies are making efforts to understand what the contribution of chemotherapy and radiotherapy with neoadjuvant and adjuvant intent may be both in unselected and selected histological subgroups. In fact, despite the improvement in overall survival seen in the past few years thanks to the adoption of a more radical surgical approach, mortality remains relatively high and the five-year overall survival is around 65%. Key messages: In this review, we comment upon the treatment of localized soft tissue sarcomas of the extremity, trunk wall and retroperitoneum and how surgery, radiotherapy and chemotherapy can be integrated with each other and individually tailored. Nomograms can assist clinicians in this complex therapeutic-decision making process, through the identification of patients at higher risk of death or disease relapse.

S. Karger AG, Basel

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