[Accomplishments of tumor surgery in tumors of soft tissues]

Surgery of sarcomas includes treatment of the primary tumor and recurrences or metastases. The surgical intervention is in most cases part of a multimodal treatment approach. The surgical technique used depends on the size, localization and extension of the tumor. By selecting the appropriate surgical technique, such as compartment resection or plastic surgical procedures, as well as additional radiation or chemotherapy, amputation of an extremity can often be avoided or at least reduced in extensiveness (stump distalisation). Of course there can be no compromise on sufficient tumor-free resection margins. Through preoperative radiation therapy or regional chemotherapy, e.g. isolated hyperthermal extremity perfusion, it is possible to improve the final results of extremity conserving therapy. A mono-bloc resection of sarcomas of localisations other than the extremities is problematical and often impossible. In the context of multimodal treatment approaches the surgical reduction of the tumor is highly significant. Even if the tumor has metastasized, the prognosis can be significantly improved by surgical procedures. This is especially true if the metastases are in the lung, in which case the disease-free interval and the tumor-doubling time are significant prognostic factors. These should be considered in the treatment of metastatic disease.