[Sarcomas: principles of surgery]

Surgery is the most important treatment for local control of sarcomas. The main difficulty is in the appreciation for each individual patient, of the solution which is expected to give the best control and the minimal functional impairment. In osteosarcoma, preoperative chemotherapy and technological advances have dramatically changed the local treatment, with more and more limb-sparing procedures being performed. The good results which have been obtained with such procedures in terms of tumor control as well as function lead now to consider an increase in the role of surgery in Ewing's sarcomas also. For soft tissue sarcomas, possibilities and results of radical surgery depend mainly on local extension and tumor localization. A good alternative can be less-than-radical tumor removal combined with post-operative radiotherapy. In extensive tumors, preoperative radiotherapy or chemotherapy may be considered.