Soft Tissue Sarcomas

Soft tissue sarcomas (STS) are malignant mesenchymal tumors that can develop at almost any anatomic location. They are usually classified as rhabdomyosarcomas and non-rhabdomyosarcoma soft tissue sarcomas (NRSTS), a term that encompasses more than 50 different histotypes. Adequate histological diagnosis and staging are critical. Treatment of STS is based on a riskadapted multimodal approach, and patients should preferably be treated within the framework of international clinical trials by expert multidisciplinary teams. These trials provide specific therapeutic recommendations for some tumor types, particularly in the case of NRSTS. Biopsy is essential within the diagnostic workup and must follow oncologic principles and provide enough tissue for pathology, molecular studies, and research. Regional lymph node sampling for adequate staging is critical in certain scenarios and might include sentinel lymph node biopsy techniques. Surgery plays a major role in treatment of STS, ideally achieving a complete resection with microscopic negative margins, whenever possible without major risks or mutilation. The resection must be planned in detail, as well as the possible reconstructive techniques. Likewise, the need for radiotherapy (neoadjuvant, adjuvant, or as the only local therapy in certain cases), should be taken into consideration. Brachytherapy has gained evidence as the best organ-preserving modality for rhabdomyosarcomas in certain anatomic locations.