Soft tissue sarcomas for trauma and orthopaedic exam candidates

Abstract

Soft tissue sarcomas (STS) represent a diverse group of malignant tumours for which surgery is the cornerstone of curative treatment. All STS patients should be managed by a specialized sarcoma multidisciplinary team (MDT). For non-metastatic STS, the surgical aim of treatment is the wide excision of the tumour. Amputations are infrequently employed as a first-line treatment, although may be required in complex or recurrent cases. Wound complications following STS surgery are not uncommon, and reconstructive surgery is key to promote healing. Radiotherapy may be utilized for large, high-grade STS, or those close to essential anatomical structures that necessitate a marginal resection. This radiotherapy may be delivered pre- (neoadjuvant) or post- (adjuvant) operatively, with the aim of reducing local recurrence rates. Systemic treatments such as chemotherapy are generally not utilized for localized STS, other than for a few, specific subtypes. In metastatic patients, systemic treatment may be employed with palliative intent. The management of localized STS recurrence follows the same principles as those of primary disease, with emphasis placed on re-staging all patients to rule out metastatic disease. Long-term patient follow-up is crucial to detect disease recurrence (local or systemic) and any significant treatment-related complications.