How I Treat Localized Soft Tissue Sarcomas: Update on Diagnosis, Risk Stratification, and Treatment

Abstract

Background: Adult-type soft tissue sarcomas (STS) are rare tumors representing about 1% of all adult malignant tumors. Their extreme histological heterogeneity places them among the most challenging fields of diagnostic pathology. The variability of clinical and prognostic presentation between the various histotypes reflects the different management that should be followed on a case-by-case basis. These features make soft tissue sarcomas the case in point of how important it is a centralized and multidisciplinary approach. Summary: Surgery represents the mainstay in the treatment of localized soft tissue sarcomas. Recently, more and more studies are making efforts to understand what the contribution of chemotherapy and radiotherapy with neoadjuvant and adjuvant intent may be both in unselected and selected histological subgroups. In fact, despite the improvement in overall survival seen in the past few years thanks to the adoption of a more radical surgical approach, mortality remains relatively high and the five-year overall survival is around 65%. Key messages: In this review, we comment upon the treatment of localized soft tissue sarcomas of the extremity, trunk wall and retroperitoneum and how surgery, radiotherapy and chemotherapy can be integrated with each other and individually tailored. Nomograms can assist clinicians in this complex therapeutic-decision making process, through the identification of patients at higher risk of death or disease relapse.

Exploration of Flavonoids as Lead Compounds against Ewing Sarcoma through Molecular Docking, Pharmacogenomics Analysis, and Molecular Dynamics Simulations

“…Previous research has found that tumors most commonly arise in the tubular bones of the extremities (46%), mostly in the lower extremities, followed by the pelvis (25%), trunk comprising ribs and spinal trunk (22%), and other locations (6%) [ 1 ]. The 5-year overall survival (OS) rate for patients with localized ES has grown to 65%, due to the use of surgery, chemotherapy, and radiation [ 4 ].…”