Soft tissue sarcoma resection
Surgery is the standard treatment for all patients with adult-type, localized soft tissue sarcoma. Dr. Jaimin Shah – Ortho Onco surgeon preforms Soft tissue sarcoma surgery with accuracy and appropriately.
Dr. Jaimin Shahdetermines the evaluation of a tumor in consultation with the MDT and depends on the tumor stage and the patient’s co-morbidity.
The primary aim of surgery is to completely excise a tumor with a margin of normal tissue.
The margin of normal tissue is not universally agreed but is commonly accepted as 1 cm soft tissue or equivalent (e.g., a layer of fascia).
Anatomical constraints mean that a true wide resection is not possible without the sacrifice of critical anatomical structures (such as major nerves, or blood vessels).
Soft tissue sarcoma surgery
It may be acceptable to leave a planned microscopic positive surgical margin. Considering the risks of recurrence and morbidity of more radical surgery and discuss these fully with the patient.
Patients who have undergone surgery and have an unplanned positive margin, a surgeon can re-excision and can achieve adequate margins.
Macroscopic residual disease imparts a poor prognosis and local control can achieve even with the addition of postoperative radiotherapy.
Patients with tumors are considered for downstaging treatment (neo-adjuvant). Either chemotherapy or radiotherapy depending on histology of the tumor and the performance status of the patient (see below).
In some situations, amputation may be the most appropriate surgical option to obtain local control and offer the best chance of cure. It is recognized that there is a group of low-grade tumors which have a low risk of local recurrence and a low risk of metastasis and it is also appropriate to treat these by planned marginal excision. (e.g., atypical lipomatous tumors).