Interdisciplinary therapy of extremity soft tissue sarcomas: current evidence on systemic treatments and the role of reconstructive surgery

TL;DR

This paper discusses the importance of interdisciplinary care in treating rare soft tissue sarcomas, emphasizing collaboration and specialized treatment for better outcomes.

Contribution

The paper highlights the role of reconstructive surgery and centralized care in achieving optimal results for complex sarcoma cases.

Findings

Interdisciplinary collaboration is critical for effective treatment of soft tissue sarcomas.

Reconstructive surgery allows for radical tumor resection while preserving function.

Early referral to specialized centers improves oncological and functional outcomes.

Abstract

Soft tissue sarcomas are rare and heterogenous tumors, that often pose diagnostic and therapeutic challenges. Guideline-compliant therapy includes surgical resection with negative margins, supplementary radiotherapy and, if necessary, accompanied by systemic therapy. Diagnostic and therapeutic approaches should be discussed and planned in an interdisciplinary oncological conference. The aim of this article is to provide an overview of guideline-based interdisciplinary therapeutic options, limitations and prospects. An exemplary case is used to illustrate interdisciplinary concepts.

A six-year-old girl with a locally advanced epithelioid sarcoma of the right hand was recommended to receive a hand amputation. Due to a request for limb-preservation, the patient presented at various sarcoma centers and initially received neoadjuvant radiotherapy. This resulted in a reduction of the tumor mass so that a tumor resection could subsequently be performed. Despite pronounced local findings, microscopically negative margins and a satisfactory postoperative result in hand function were achieved.

This case highlights the critical role of interdisciplinary collaboration and centralized care in the treatment of soft tissue sarcomas. Plastic reconstructive surgery enables radical oncological resection while preserving function, especially in anatomically complex cases. Early referral to a specialized sarcoma center and adherence to current guidelines (e.g., ESMO-EURACAN-GENTURIS) are essential to achieving optimal oncological and functional outcomes.

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