Multimodality therapy for advanced or metastatic sarcoma

Patients with widespread metastatic disease are best managed with chemotherapy. The choice of regimen should be determined based on the patient's performance status, symptom burden, and the toxicity profile of agents to be used. Select patients with oligometastatic or limited metastatic disease may benefit from surgical metastasectomy or interventional radiology-based approaches for disease control. In retrospective series, impressive 5-year survival rates of up to 50% have been documented. Given the absence of randomized controlled trials and the diversity of STS clinical behavior, it is best that these treatment decisions are made in a multidisciplinary setting with pathologists, medical oncologists, radiation oncologists, and surgeons who specialize in the care of such patients.