What is the role of surgery in the treatment of nonextremity soft-tissue sarcomas?

Updated: Dec 03, 2018
  • Author: Vinod B Shidham, MD, FRCPath; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Answer

As with sarcomas of extremities, options for therapeutic management of nonextremity sarcomas include surgery, radiation, and chemotherapy.

Sarcomas arising in the head and neck, thoracic or abdominal wall, mediastinum, or retroperitoneum are difficult to treat. Most of these tumors develop in areas where surrounding normal tissue limits the maximum dosage of radiation that can safely be delivered to the tumor bed. In general, the risk of local recurrence is high. For retroperitoneal tumors, the patient usually succumbs as a result of local complications, before metastases are evident.

In a subgroup analysis of the prospectively randomized EORTC 62961 phase III trial, Angele et al determined that the addition of regional hyperthermia (RHT) to systemic chemotherapy yielded significant improvements in local progression-free survival (LPFS) and disease-free survival (DFS) after resection of high-risk retroperitoneal and abdominal soft tissue sarcomas, as compared with chemotherapy alone. [46] However, no significant improvements were noted in overall survival or perioperative morbidity and mortality.


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