Abstract
Soft tissue sarcoma is a rare malignancy, with approximately 11,000 cases per year encountered in the United States. It is primarily encountered in adults but can affect patients of any age. There are many histologic subtypes and the malignancy can be low or high grade. Appropriate staging work up includes a physical exam, advanced imaging, and a carefully planned biopsy. This information is then used to guide the discussion of definitive treatment of the tumor which typically involves surgical resection with a negative margin in addition to neoadjuvant or adjuvant external beam radiation. Advances in imaging and radiation therapy have made limb salvage surgery the standard of care, with local control rates greater than 90% in most modern series. Currently, the role of chemotherapy is not well defined and this treatment is typically reserved for patients with metastatic or recurrent disease and for certain histologic subtypes. The goal of this paper is to review the current state of the art in multidisciplinary management of soft tissue sarcoma.
Highlights
The Scientific World Journal review the principles and issues surrounding the diagnosis and treatment of soft tissue sarcoma
If Magnetic resonance imaging (MRI) is not feasible due to an incompatible medical device or high-risk metallic foreign body, a computerized tomography (CT) scan with and without intravenous contrast is recommended with 3D reconstruction so as to assess local extent of disease in longitudinal and axial planes
In addition to cross-sectional imaging of the mass, additional staging studies of a suspected or diagnosed soft tissue sarcoma should include a CT scan of the chest to evaluate for pulmonary metastases
Summary
Soft tissue sarcomas are a relatively rare and heterogeneous group of malignancies that are characterized by mesodermal differentiation [1]. It was estimated that in 2012 there would be 11,280 new cases of soft tissue sarcoma in the United States, making the diagnosis approximately three to four times more common than primary bone sarcoma [3]. Optimal management of soft tissue sarcoma relies upon an appropriately performed biopsy, accurate diagnosis and staging, an effective surgical plan and execution, rational utilization of adjuvant therapies, and close surveillance following resection. This is best carried out at a tertiary care center with an experienced multidisciplinary team specializing in the care of sarcoma patients. The Scientific World Journal review the principles and issues surrounding the diagnosis and treatment of soft tissue sarcoma
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