Extremity Soft Tissue Sarcoma: Role of Local Control.

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Localized extremity soft tissue sarcoma (eSTS) is rare and requires specialized care.
• Treatment for eSTS is highly individualized and managed by multidisciplinary teams at sarcoma centers.
• Current treatment paradigms focus on limb-sparing approaches.

Purpose of the Study:

• To provide an opinion statement on the optimal management of localized extremity soft tissue sarcoma.
• To outline the roles of surgery, radiation therapy, and chemotherapy in eSTS treatment.
• To emphasize the importance of specialized care and surgical expertise.

Main Methods:

• This is an opinion statement based on current evidence and expert consensus.
• Recommendations are derived from the analysis of existing literature on eSTS management.
• Clinical experience from specialized sarcoma centers informs the guidelines.

Main Results:

• Limb-salvage surgery is the cornerstone of eSTS treatment, ideally performed by fellowship-trained surgeons.
• Radiation therapy is crucial for achieving negative margins when wide resection is not feasible, preserving critical structures.
• Surgery alone may suffice for select small, low-grade, superficial tumors with wide margins (>2 cm).

Conclusions:

• Preoperative radiation and wide re-excision are recommended for inadvertent excisions due to high residual tumor rates.
• Radiotherapy is well-supported for enhancing local tumor control in eSTS.
• Evidence supporting chemotherapy for local control in eSTS is lacking, thus it is not universally recommended.