Callegaro Dario, Sarre Lazcano Catherine, Cardona Kenneth
Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Department of Surgery, London Health Sciences Centre, University of Western Ontario, London, ON, Canada.
Ann Surg Oncol. 2025 Sep 10. doi: 10.1245/s10434-025-18223-7.
Soft tissue sarcomas (STS) are a heterogeneous group of rare malignant tumors arising from mesenchymal tissues, with extremity and superficial trunk STS (eSTS) comprising the majority of cases. The management of localized eSTS requires a multidisciplinary approach to optimize oncologic and functional outcomes. This review outlines the natural history, diagnostic workup, and treatment principles for localized eSTS, emphasizing the role of histology-specific considerations in guiding management strategies. While surgery remains the mainstay of treatment, with the goal of achieving negative margins and preserving limb function, radiotherapy is frequently employed to reduce the risk of local recurrence. Systemic therapies, including chemotherapy and immunotherapy, are increasingly being explored in both the neoadjuvant and adjuvant settings. Recent evidence suggests that chemotherapy may provide a survival benefit in selected high-risk patients. Additionally, emerging data on immune checkpoint inhibitors indicate potential efficacy in specific histologic types and in combination with radiotherapy. Given the complexity of diagnosis and treatment, centralization of care in specialized sarcoma centers is critical to ensure optimal patient outcomes.
软组织肉瘤（STS）是一组起源于间充质组织的异质性罕见恶性肿瘤，其中肢体和浅表躯干软组织肉瘤（eSTS）占大多数病例。局限性eSTS的治疗需要多学科方法，以优化肿瘤学和功能结局。本综述概述了局限性eSTS的自然病史、诊断检查和治疗原则，强调了组织学特异性考虑因素在指导管理策略中的作用。虽然手术仍然是主要治疗方法，目标是实现切缘阴性并保留肢体功能，但放疗经常用于降低局部复发风险。全身治疗，包括化疗和免疫治疗，在新辅助和辅助治疗中越来越多地被探索。最近的证据表明，化疗可能在选定的高危患者中提供生存益处。此外，关于免疫检查点抑制剂的新数据表明，其在特定组织学类型以及与放疗联合使用时具有潜在疗效。鉴于诊断和治疗的复杂性，在专业肉瘤中心集中治疗对于确保患者获得最佳结局至关重要。
