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A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing Neoadjuvant Therapies
Published on: July 28, 2020
Evaluation of Treatment Modalities and Oncologic Outcomes in Hand Soft Tissue Sarcomas-A Systematic Review of the
W Rodrigo Calmet Rocca1, Rayna S Kuthiala2, Marcos R Gonzalez2,3
1Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima 15102, Peru.
Background/Objectives:
Soft tissue sarcomas (STS) of the hand are rare, representing only 2% of all STS. The small size and benign appearance of these tumors often lead to unplanned excisions and diagnostic delay. This systematic review sought to characterize the clinical presentation, histology, treatment modalities, and oncological outcomes of hand STS.
Methods:
A systematic review of PubMed and Embase was conducted following PRISMA guidelines. The protocol was registered on PROSPERO. We included studies with ≥10 patients with STS that provided data on treatment options and oncologic outcomes. Data was extracted regarding demographics, tumor features, treatment modalities, and survival metrics.
Results:
Eighteen studies comprising 570 patients were included. Most tumors were <5 cm, and 56.8% were deep (subfascial). Epithelioid and synovial sarcomas were the most common histologies, accounting for 27% and 17% of cases, respectively. UEs were seen in 57% of cases, and 26% of patients required amputation. Positive surgical margins were reported in 16% of patients. Radiation therapy and chemotherapy were used in 40% and 17% of patients, respectively. Twelve and 15% of patients developed regional lymph node and distant metastases, respectively. Local recurrence occurred in 20% of cases. Five- and ten-year overall survival were 80% and 77%, respectively. Disease-free survival at those time points were 77% and 74%, respectively.
Conclusions:
Hand STSs are challenging due to their rarity, small size, and high rates of UEs. Despite favorable survival rates, local recurrence and metastases remain a concern. Early referral to specialized centers and individualized treatment strategies are essential for improving outcomes.
Insights
Hand soft tissue sarcomas (STS) are rare and challenging. Despite good survival, early referral and tailored treatments are crucial for managing local recurrence and metastases in these challenging hand tumors.
Area of Science:
- Oncology
- Surgical Pathology
- Orthopedic Oncology
Background:
- Soft tissue sarcomas (STS) of the hand are rare, comprising only 2% of all STS.
- Their small size and often benign appearance contribute to delayed diagnosis and unplanned excisions.
- Hand STS present unique challenges in clinical presentation, histology, and treatment.
Purpose of the Study:
- To systematically review and characterize the clinical presentation of hand STS.
- To analyze histology, treatment modalities, and oncological outcomes for hand STS.
- To identify factors influencing outcomes and inform treatment strategies for hand STS.
Main Methods:
- Systematic review of PubMed and Embase databases following PRISMA guidelines.
- Inclusion of studies with at least 10 patients and data on treatment and outcomes.
- Data extraction included demographics, tumor features, treatments, and survival metrics.
Main Results:
- Eighteen studies with 570 patients were analyzed.
- Epithelioid and synovial sarcomas were most common; 56.8% of tumors were deep-seated.
- Local recurrence occurred in 20%, with 5-year overall survival at 80%.
Conclusions:
- Hand STS are difficult to manage due to rarity, small size, and frequent unplanned excisions.
- While survival rates are favorable, local recurrence and metastases remain significant concerns.
- Specialized center referral and individualized treatment are vital for optimal hand STS management.
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