What are the NCCN treatment guidelines for retroperitoneal/intra-abdominal soft tissue sarcoma (STS)?

Updated: Sep 02, 2018
  • Author: Steven C Katz, MD, FACS; Chief Editor: Edwin Choy, MD, PhD  more...
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Answer

Answer

For resectable disease, NCCN recommends surgery with or without intraoperative RT; preoperative therapy with RT and chemotherapy are options. [1] Dissection should be through grossly normal tissue planes not involved with tumor. Radical compartmental approaches are not routinely required. Close margins may be necessary to preserve critical neurovascular structures and hence function and quality of life.

For unresectable disease, the NCCN recommends initial chemotherapy or RT to induce a response, followed by resection if feasible. The NCCN advises always considering resection of resectable metastatic disease if the primary tumor can be controlled. If the disease is still unresectable after neoadjuvant therapy or is progressive, considerations include the following [1]

  • Palliative chemotherapy
  • Palliative RT
  • Palliative surgery for symptom control
  • Observation if the patient is asymptomatic

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