Hettler Madelaine, Jakob Jens
Sektion Sarkomchirurgie, Chirurgische Klinik, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
Chirurgie (Heidelb). 2025 Jun;96(6):524-534. doi: 10.1007/s00104-025-02267-2. Epub 2025 Mar 19.
Soft tissue sarcomas are rare malignant tumors originating from mesenchymal tissue. They are mostly located in the extremities, followed by the trunk and retroperitoneal regions. The group of soft tissue sarcomas comprises over 80 distinct histological subtypes, each with unique biological characteristics, with liposarcomas and leiomyosarcomas being the most frequent subtypes. In the clinical practice the algorithm from image, biopsy and (sarcoma) board has become established for the diagnostics of any soft tissue space-occupying lesion exceeding 3 cm in size. This enables the planning of a wide R0 resection, which can be defined as the standard for sarcoma surgery. For locally advanced and/or frequently metastasizing tumors, (neo)adjuvant radiotherapy and/or chemotherapy are usually indicated. Patients benefit from a sarcoma board to determine the treatment strategy. After treatment, clinical and radiological follow-ups should be conducted every 3-6 months, depending on the grade of the primary tumor.
软组织肉瘤是起源于间叶组织的罕见恶性肿瘤。它们大多位于四肢，其次是躯干和腹膜后区域。软组织肉瘤组包括80多种不同的组织学亚型，每种亚型都有独特的生物学特性，其中脂肪肉瘤和平滑肌肉瘤是最常见的亚型。在临床实践中，针对任何大小超过3厘米的软组织占位性病变，已确立了从影像学、活检到（肉瘤）多学科会诊的诊断流程。这有助于规划广泛的R0切除，可将其定义为肉瘤手术的标准。对于局部晚期和/或频繁转移的肿瘤，通常需要进行（新）辅助放疗和/或化疗。患者受益于肉瘤多学科会诊以确定治疗策略。治疗后，应根据原发肿瘤的分级每3至6个月进行临床和影像学随访。
