A review of soft tissue sarcoma

Soft tissue sarcomas (STS) are a heterogeneous group of rare tumours that arise predominantly from the embryonic mesoderm. They present most commonly as an asymptomatic mass originating in an extremity but can occur anywhere in the body, particularly the trunk, retroperitoneum, or the head and neck. They account for about 0.7% of all adult malignancies.

A review of the literature of STS was undertaken with emphasis on current approach in management.

Despite recent advances in the knowledge of the molecular biology of STS, there is yet no identifiable aetiology in most cases. Tru-cut biopsy is a safe, accurate and economical procedure for diagnosing STS. Enough tissue is usually obtained for use in several diagnostic tests such as electron microscopy and cytogenetic analysis. With the advent of Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA), tumours can easily be delineated from muscle groups, bone and neurovascular structures. Surgery remains the main potentially curative therapy for STS. In the last two decades, the role of adjuvant radiotherapy has revolutionized the treatment from a situation where amputation was the standard treatment for extremity STS to the present time where limb sparing surgery is appropriate in more than 90% of patients. Postoperative adjuvant chemotherapy significantly improves the overall and disease free survival for patients with large size and high grade sarcomas.

Optimal results of treatment require multidisciplinary interaction between the referring practitioner, the treating surgeon, the pathologist, the radiotherapist and the chemotherapist.