Defining Which Patients Are at High Risk for Recurrence of Soft Tissue Sarcoma

Several studies have investigated the prognosis of soft tissue sarcomas and the influence of a variety of factors, such as size, histology subtype, malignancy grade, site, margins, on overall survival, recurrence-free survival, incidence of local and distant spreading. The impact of genomic and expression profiling on long-term outcomes of patients with sarcomas has been also evaluated in order to fill the knowledge gap of this heterogeneous disease. Nomograms represent a prognostic tool that extends the standard staging systems on an individualized basis, taking into account tumor- and patient-related factors. They are used to assist the health provider and the patients in the decision-making process, for patient counseling, treatment decision-making, follow-up scheduling, and clinical trial eligibility determination. None of the available nomograms include molecular characterization of sarcomas. In the future, omics signatures might be incorporated into prognostic nomograms possibly improving their performance. In the present review, we focus on the complexity of prognostic and predictive factors for extremity and trunk wall as well as for retroperitoneal soft tissue sarcomas, while exploring the available prognostic models.