Treatment for soft tissue sarcomas is determined mainly by the stage of the disease. The stage depends on the size of the tumor, the grade, and whether the cancer has spread to the lymph nodes or other parts of the body. The most important component of the stage is the tumor grade (how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread). Treatment options for soft tissue sarcomas include surgery, radiation therapy, and chemotherapy. A multidisciplinary team of cancer specialists can help plan the best treatment for patients with soft tissue sarcomas.
Surgery is the usual treatment for soft tissue sarcomas. For surgery to be effective, the surgeon must remove the entire tumor with negative margins (no cancer cells are found at the edge or border of the tissue removed during surgery). The surgeon may use special surgical techniques to minimize the amount of healthy tissue removed with the tumor. Some patients need reconstructive surgery.
Radiation therapy involves the use of high-energy x-rays to kill cancer cells. This therapy may be used before surgery to shrink the tumor, after surgery to kill any cancer cells that may remain in the body, or both before and after surgery. Radiation may come from a machine outside the body (external radiation therapy). It can also come from radioactive materials placed directly into or near the area where the cancer cells are found (internal radiation therapy or radiation implant).
Chemotherapy is the use of anticancer drugs to kill cancer cells. Chemotherapy may be used before or after surgery, and with or without radiation therapy.
The effectiveness of current anticancer drugs depends on the type of sarcoma. Some sarcomas are very responsive to chemotherapy, while others do not respond to current anticancer drugs. Some sarcomas with specific chromosomal alterations can be treated with therapies targeted to the alteration.