SEOM Clinical Guideline of management of soft-tissue sarcoma (2016)

• Published in: Clinical & translational oncology 2016-12, Vol.18 (12), p.1213-1220
• Main Authors: López-Pousa, A., Martin Broto, J., Martinez Trufero, J., Sevilla, I., Valverde, C., Alvarez, R., Carrasco Alvarez, J. A., Cruz Jurado, J., Hindi, N., Garcia del Muro, X.
• Format: Article
• Language: English
• Subjects: Clinical Guides in Oncology; Humans; Medicine; Medicine & Public Health; Neoplasm Grading; Neoplasm Metastasis; Oncology; Practice Guidelines as Topic; Sarcoma - diagnosis; Sarcoma - therapy; Soft Tissue Neoplasms - diagnosis; Soft Tissue Neoplasms - therapy; Spain
• ISSN: 1699-048X; 1699-3055
• DOI: 10.1007/s12094-016-1574-1

Soft-tissue sarcomas are uncommon and heterogeneous tumors of mesenchymal origin. A soft-tissue mass that is increasing in size, greater than 5 cm, or located under deep fascia are criteria for suspicion of sarcoma. Diagnosis, treatment, and management should preferably be performed by a multidisciplinary team in reference centers. MRI and lung CT scan are mandatory for local and distant assessment. A biopsy indicating histological type and grade is needed previous to the treatment. Wide surgical resection with tumor-free tissue margin is the primary treatment for localized disease. Radiotherapy is indicated in large, deep, high-grade tumors, or after marginal resection not likely of being improved with reexcision. Neoadjuvant and adjuvant chemotherapy improve survival in selected cases, usually in high-grade sarcomas of the extremities. In the case of metastatic disease, patients with exclusive lung metastasis could be considered for surgery. First-line treatment with anthracyclines (or in combination with ifosfamide) is the treatment of choice. New drugs have shown activity in second-line therapy and in specific histological subtypes.