This guideline outlines the multidisciplinary diagnosis, surgical, and medical management of soft-tissue sarcomas.
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Soft-tissue sarcomas are uncommon and heterogeneous tumors of mesenchymal origin. A soft-tissue mass that is increasing in size, greater than 5 cm, or located under deep fascia are criteria for suspicion of sarcoma. Diagnosis, treatment, and management should preferably be performed by a multidisciplinary team in reference centers. MRI and lung CT scan are mandatory for local and distant assessment. A biopsy indicating histological type and grade is needed previous to the treatment. Wide surgical resection with tumor-free tissue margin is the primary treatment for localized disease. Radiotherapy is indicated in large, deep, high-grade tumors, or after marginal resection not likely of being improved with reexcision. Neoadjuvant and adjuvant chemotherapy improve survival in selected cases, usually in high-grade sarcomas of the extremities. In the case of metastatic disease, patients with exclusive lung metastasis could be considered for surgery. First-line treatment with anthracyclines (or in combination with ifosfamide) is the treatment of choice. New drugs have shown activity in second-line therapy and in specific histological subtypes.
Guides multidisciplinary soft-tissue sarcoma care now; extends evidence synthesis into standardized clinical recommendations.
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Pousa et al. (2016) conducted a review in Soft-tissue sarcoma. Multidisciplinary management and treatment guidelines was evaluated. The SEOM clinical guidelines provide evidence-based recommendations for the multidisciplinary diagnosis, surgical resection, radiotherapy, and systemic treatment of soft-tissue sarcomas.
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