Diagnosis and treatment of soft tissue sarcomas in adults

Soft tissue sarcomas account for approximately 1% of all malignancies. They constitute a wide range of different tumor types with very different clinical courses and treatment sensitivities. Our understanding of the molecular mechanisms of tumor growth in sarcomas is increasing rapidly. These new data will probably lead to drastic changes in our current classification systems, which are primarily based on routine microscopy. This might also bring about a more detailed and reliable prognostic evaluation in individual tumors. Hopefully, this knowledge will guide us towards a more rational and more successful development of new therapies. Current surgical approaches and treatment protocols are more or less well defined. Knowledge on when to use ionizing radiation for local control is reasonably clear. Major difficulties however remain for both these treatment modalities in cases of both truncal and retroperitoneal sarcomas. The lack of new very active chemotherapeutic agents against this group of diseases has remained unchanged in the past years, although both the taxanes and the topoisomerase I inhibitors show some activity.