Multidisciplinary treatment for adult soft tissue sarcoma

The current standard in local treatment of soft tissue sarcomas has shifted from amputation and similar mutilating resections to more organ- and function-preserving surgery. This was possible through multidisciplinary treatment approaches, particularly those including adjuvant radiation therapy. Adjuvant radiation showed significant improvement in local tumour control after resection with tight margins and in high-risk sarcomas. Unfortunately adjuvant radiation failed to improve overall survival. Perioperative chemotherapies also have not contributed to improvement in the overall prognosis worldwide. Progress may occur when the pathogenesis and molecular profile of specific sarcoma subtypes are better understood, allowing more effective new drugs. One example is the treatment of advanced gastrointestinal stromal tumour with imatinib, a small molecular kinase inhibitor of the c-kit receptor. Presently the most effective measure to improve the prognosis with soft tissue sarcomas is early patient referral to expert centres, where diagnostic workup and therapy decisions are made on a multidisciplinary basis and updated according to the newest guidelines and study results.