Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
Department of Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy..
Semin Radiat Oncol. 2024 Apr;34(2):147-163. doi: 10.1016/j.semradonc.2023.12.001.
Extremity and truncal soft tissue sarcomas are a heterogeneous group of rare cancers that arise from mesenchymal tissues. Hence, the adoption of tailored risk assessment and prognostication tools plays a crucial role in optimizing the decision-making for which of the many possible treatment strategies to select. Management of these tumors requires a multidisciplinary strategy, which has seen significant development in recent decades. Surgery has emerged as the primary treatment approach, with the main goal of achieving microscopic negative tumor margins. To reduce the likelihood of local recurrence, loco-regional treatments such as radiation therapy and isolated limb perfusion are often added to the treatment regimen in combination with surgery. This approach also enables surgeons to perform limb-sparing surgery, particularly in cases where a positive tumor margin is expected. Chemotherapy may also provide a further benefit in decreasing the probability of local recurrence or reducing distant metastasis in selected patients. Selecting the optimal treatment strategy for these rare tumors is best accomplished by an experienced multi-disciplinary team.
肢体和躯干软组织肉瘤是一组起源于间叶组织的罕见癌症，具有异质性。因此，采用量身定制的风险评估和预后工具对于优化决策，选择众多可能的治疗策略中的哪一种至关重要。这些肿瘤的治疗需要多学科策略，近几十年来取得了重大进展。手术已成为主要的治疗方法，主要目标是实现肿瘤边缘的显微镜下阴性。为了降低局部复发的可能性，通常在手术的基础上联合应用局部区域治疗（如放射治疗和隔离肢体灌注）。这种方法还使外科医生能够进行保肢手术，特别是在预计肿瘤边缘阳性的情况下。化疗也可能在某些患者中降低局部复发的概率或减少远处转移的风险。通过经验丰富的多学科团队，为这些罕见肿瘤选择最佳的治疗策略是最有效的。
