ASO Practice Guidelines Series: Soft Tissue Sarcoma of the Extremities and Superficial Trunk

Area of Science:

• Oncology
• Surgical Oncology
• Medical Oncology

Background:

• Soft tissue sarcomas (STS) are rare, heterogeneous cancers originating from mesenchymal tissues.
• Extremity and superficial trunk STS (eSTS) represent the most common subtype.
• Effective management necessitates a multidisciplinary approach for optimal oncologic and functional results.

Purpose of the Study:

• To review the natural history, diagnosis, and treatment principles for localized eSTS.
• To highlight the importance of histology-specific management strategies.
• To discuss the evolving roles of surgery, radiotherapy, and systemic therapies.

Main Methods:

• Review of current literature on localized eSTS.
• Emphasis on multidisciplinary care models.
• Integration of surgical, radiotherapeutic, and systemic treatment modalities.

Main Results:

• Surgery is the cornerstone for localized eSTS, aiming for negative margins and limb preservation.
• Radiotherapy is crucial for reducing local recurrence rates.
• Systemic therapies, including chemotherapy and immunotherapy, are increasingly utilized, with chemotherapy showing survival benefits in select high-risk cases and immunotherapy demonstrating potential in specific subtypes.

Conclusions:

• Histology-specific considerations are vital for tailoring eSTS treatment.
• Multidisciplinary management and centralization of care in specialized sarcoma centers are critical for improving patient outcomes.
• Emerging systemic therapies offer new avenues for treatment, particularly in advanced or high-risk disease.