Surgical management of soft tissue sarcomas

Surgical therapy is an essential component of the treatment for soft tissue sarcomas. Although multimodality treatment has become more common for sarcomas, to achieve local control and potential cure, surgical resection of the primary tumor is necessary. The selection of the overall treatment regime for soft tissue sarcomas is predicated on tumor histology, grade, prior treatment, and to some extent on anatomic location. The surgical principles important for local tumor control are complete en bloc excision of the tumor, and pathology confirmation of tumor-free margins. The operative procedures vary with the anatomic location of the primary tumor, but the principle of pathologic free margins remains. Nonamputative resection is possible in the majority of extremity soft tissue sarcomas. Surgical resection of metastatic disease has been of value in selected patients.