What is the recommendation for soft tissue sarcoma treatment?

The entire tumour should be removed along with at least 1cm of tissue surrounding the tumour, ensuring that the tissue surrounding the tumour is cleared of any cancer cells. Removal of a margin of less than 1cm is acceptable if it is in order to preserve critical structures.

It is recommended to treat with radiotherapy after surgery if the tumour is large, deep or of high/intermediate grade. Cancers are given different grades for categorisation that indicate the severity of the disease. A high grade disease indicates that cancergrowth is fast.

It is standard for radiotherapy given before surgery to be followed by surgery approximately 6 weeks following completion of radiotherapy. Further radiotherapy may be given after the surgery if the tissue surrounding the tumour is found to have cancer cells. Radiation dose is lower when radiation is given before as compared to after surgery.

Radiotherapy is not routinely given before surgery, but may be preferred in certain situations where radiation required for treatment after the surgery is likely to be associated with significant disease, or when the tumour is almost suitable for surgical removal and treatment before surgery with radiotherapy is judged to be capable of making the tumour suitable for surgical removal. In such situations, types of cancers that are more sensitive to radiation like myxoid liposarcoma may benefit from this approach.

Adjuvant chemotherapy is controversial and best discussed on a case-by-case basis.A drug taken in an adjuvant setting is given together with another treatment to increase its effectiveness.