Surgical resection of isolated pulmonary metastases from soft tissue sarcomas can achieve 3-year survival rates of 20% to 30%, whereas unresectable metastatic disease has a uniformly poor prognosis.
This review outlines the management of soft tissue sarcomas, emphasizing surgical resection, adjuvant radiation for local control, and chemotherapy for disseminated disease.
Soft tissue sarcomas are relatively rare tumors with an annual incidence of 5000 to 6000 in the United States. The primary therapy is surgical resection with an adequate margin of normal tissue. For patients at high risk local control is improved with postoperative adjuvant radiation. Local recurrence rates vary depending on the anatomic site. In extremity lesions one third of patients will have locally recurrent disease with a median disease-free interval of 18 months. Treatment results for extremity local recurrence may approach those for primary disease. Isolated pulmonary metastases may be resected with 20% to 30% 3-year survival rates. Patients with sarcomas in other sites present similar but more difficult problems in terms of local control and management of disseminated disease. Patients with unresectable pulmonary metastases or extrapulmonary metastatic sarcoma have a uniformly poor prognosis and are best treated with systemic chemotherapy.
Lewis et al. (1996) conducted a review in Soft tissue sarcomas. Surgical resection of isolated pulmonary metastases from soft tissue sarcomas can achieve 3-year survival rates of 20% to 30%, whereas unresectable metastatic disease has a uniformly poor prognosis.