The management of soft tissue sarcomas

The management of soft tissue sarcomas presents one of the more exciting areas of the application of multimodal therapy for malignancy. Rapid developments have taken place in the understanding of the histogenesis, histopathology, prognostic indicators and treatment approaches. With the combination of local irradiation and adjuvant chemotherapy, limb sparing operations can now be widely advocated with amputation being reserved for proximal difficult lesions. Retroperitoneal sarcomas, however, remain a major challenge with little progress in results of therapy, other than improved operative morbidity in the last 10-15 years. Current prospective, randomized studies of the management policies designed to maximize survival while minimizing morbidity should provide further insights in the near future. Our current and past experience with more than 150 new cases each year allows a brief summary of the understanding and management of these difficult problems.