Clinical Evaluation and Treatment of Soft Tissue Tumors

Soft tissue sarcomas are uncommon and frequently missed on examination, resulting in delays in diagnosis and, occasionally, inappropriate treatment. Sarcoma staging, the process of defining the local extent of tumor and potential distant spread, involves a thorough history and physical examination, directed imaging, and biopsy. Biopsy is a complicated procedure in approximately 20% of cases and should be performed only by experienced personnel and at a center with a multidisciplinary team familiar with the treatment of patients with soft tissue sarcomas. The goal of surgery is to obtain tumor-free margins. In conjunction with radiation therapy, surgery can then provide local disease control in more than 90% of patients. The role of chemotherapy in nonmetastatic disease is unclear and is of marginal efficacy in patients with metastases. Although most tumors recur within 2 to 5 years, long-term clinical and radiographic surveillance is necessary.