Diagnosis and Therapy of Soft Tissue Sarcomas: Spanish Group for Research in Sarcomas (GEIS) Guidelines

TL;DR

This paper presents guidelines for diagnosing and treating soft tissue sarcomas, emphasizing the importance of specialized centers and multidisciplinary approaches.

Contribution

The paper introduces comprehensive, evidence-based guidelines developed by a Spanish expert group to improve the management of soft tissue sarcomas.

Findings

MRI is recommended as the preferred imaging modality before biopsy for soft tissue sarcomas.

Specialized sarcoma centers with multidisciplinary teams are crucial for accurate diagnosis and treatment.

Abstract

Soft tissue sarcomas are rare, heterogeneous tumors requiring management in expert, multidisciplinary reference centres. Early suspicion, appropriate imaging (MRI as first choice), and core needle biopsy performed in referral centres are critical for diagnosis. Surgery with clear margins is the cornerstone of localized treatment, complemented by radiotherapy and chemotherapy in selected cases. Treatment of advanced or metastatic disease should be tailored to histologic subtype, with systemic therapy options including anthracyclines, ifosfamide, trabectedin, gemcitabine combinations, eribulin and targeted agents. Molecular diagnostics and participation in clinical trials are strongly encouraged to improve outcomes.

Soft tissue sarcomas (STSs) are a rare and highly heterogeneous group of tumours originating from mesenchymal cells, characterized by significant clinical and biological diversity. Due to this complexity, STSs present considerable challenges in both diagnosis and treatment, requiring an expert, multidisciplinary, and coordinated approach. To address these challenges, a multidisciplinary team of experts from the Spanish Group for Research in Sarcomas (GEIS) has developed a comprehensive, evidence-based consensus guideline that incorporates the latest advancements in biology, imaging techniques, and treatment options. The primary objective of this guideline is to provide clear and practical, up-to-date recommendations addressing the key questions that arise in the management of STSs. This approach aims to support therapeutic decision-making, enhance overall patient management, and ultimately improve clinical outcomes for patients affected by STSs. Key recommendations include the use of MRI as the preferred imaging modality prior to biopsy and ensuring that all patients are referred to specialised sarcoma centres with a multidisciplinary team for diagnosis and treatment.