The surgical management of soft tissue sarcomas (STS)

Hippokratia 1999, 3(1):33-37

N. Sikas, JM Thomas


Soft tissue sarcomas are rare, comprising only 1% of all malignancies. Excision of the tumour with clear margins both macroscopically and microscopically is the most effective way of management. In a 6-month time period, at The Royal Marsden Hospital of London, 59 patients with the diagnosis of primary or recurrent STSs, were treated. They were 29 men and 30 women and their age ranged between 18 and 80. Most of them were located in the upper and lower limbs. The main symptom was a palpable mass and in the diagnosis contributed the Tru-Cut biopsy as well as computed tomography and MRI. For the management of these STSs, wide excision was performed in 37 cases, re-excision of residual tumour in 6, debulking in 9, amputation in 5 and exploratory laparotomy in 3. Chemotherapy was given pre-operatively in 4 patients and post-operatively in 3. Radiotherapy was administered pre-operatively in 1 patient and post-operatively in 12. Histologically the commonest lesions were liposarcoma and leiomyosarcoma.In conclusion, the diagnosis of STS should be considered in toumours arising deeper to deep fascia and increase in size within a short period of time. Tru-Cut biopsy is the method of choice in pre-operative diagnosis. The accurate pre-operative diagnosis and the wide excision of the tumour followed by radiotherapy result in a very low recurrence rate.