Soft tissue sarcoma (STS) is a type of tumor accounting for 0.8% of all malignancies. This percentage rises to 6.5% in children and adolescents under the age of 15. The number of new cases diagnosed in 2008 in the USA was 10,390 with 3,680 deaths.
Soft tissue sarcomas are malignant tumors that can develop in any of the mesodermal tissues of the extremities (50%), trunk and retroperitoneum (40%), or head and neck (10%). On rare occasions these tumors develop in the gastrointestinal tract or stroma and a minimum percentage of cases are known as gastrointestinal stromal tumors (GIST). Malignant GIST can develop between the esophagus and the rectum but they appear more commonly in the stomach and small intestine.
Most STS originate in the extremities and treatment is almost always surgical. This involves the complete removal of the tumor according to oncological guidelines, i.e. with about 2-cm margins. This surgery can sometimes be very mutilating with the need for limb amputations in some cases.
Our group prefers to perform wide excisions of these tumors but if this results in mutilation or functional loss of a limb, we offer treatment prior to surgery, which may reduce the size of the tumor and allow excision of the tumor with fewer amputations and sequelae. This technique is known as Isolated Limb Perfusion (ILP) (see melanomas).
With regards to abdominal sarcomas, our group is in favor of performing wide excisions of these tumors, which may sometimes mean removing adjacent organs affected by the tumor. This results in higher survival rates and improved quality of life for these patients.