Unit of Orthopedic Oncology, Orthopedic Division, Hillel-Yaffe Medical Center, Hadera, Israel, affiliated with the Rappaport Faculty of Medicine, The Technion, Haifa, Israel.
Department of Orthopedic Surgery, Georgetown University School of Medicine, Washington, DC.
J Bone Joint Surg Am. 2022 Feb 16;104(4):379-389. doi: 10.2106/JBJS.21.00196.
➤: Soft-tissue sarcomas (STS) in adults comprise a heterogeneous group of tumors of mesenchymal origin that share similar biological patterns of local tumor growth and metastatic dissemination.
➤: The judicious use of imaging studies, biopsy techniques, and pathological evaluations is essential for accurate diagnosis and for planning treatment strategy.
➤: Wide local resection and radiation therapy form the cornerstone of management of high-grade STS. The role of adjuvant radiation therapy is questionable in the management of small (≤5 cm) superficial lesions that can be resected with negative margins. Chemotherapy given to patients who have nonmetastatic, high-grade STS results in varying benefit in terms of local tumor control and overall survival.
➤: Coordinated care by a multidisciplinary team of trained surgeons, medical oncologists, radiologists, radiation oncologists, and pathologists has been documented to improve local tumor control and the overall survival of patients with STS.
➤: Although considerable progress in tumor diagnostics and targeted therapies has been made over the past 2 decades, recommendations and controversies relating to tumor imaging and margins of resection have not changed.
➤: 成人软组织肉瘤（STS）是一组起源于间叶组织的异质性肿瘤，具有相似的局部肿瘤生长和转移扩散的生物学模式。
➤: 明智地使用影像学研究、活检技术和病理学评估对于准确诊断和制定治疗策略至关重要。
➤: 广泛局部切除和放疗是治疗高级别 STS 的基石。对于可以通过阴性切缘切除的小（≤5cm）表浅病变，辅助放疗在管理中的作用存在争议。对于患有非转移性、高级别 STS 的患者，给予化疗在局部肿瘤控制和总体生存方面的获益不同。
➤: 由受过训练的外科医生、肿瘤内科医生、放射科医生、放射肿瘤学家和病理学家组成的多学科团队的协调护理已被证明可以提高 STS 患者的局部肿瘤控制和总体生存率。
➤: 尽管在过去的 20 年中，在肿瘤诊断和靶向治疗方面取得了相当大的进展，但与肿瘤成像和切除边界相关的建议和争议并没有改变。
