[Sarcomas of soft tissue in the adult. Therapeutical indications]. / Sarcomes des tissus mous de l'adulte. Indications therapeutiques.

ABSTRACT

Treatment of soft-tissue sarcomas has to deal simultaneously with three goals 1) to obtain the control of the primary tumor, 2) to preserve the function, and 3) to treat the micrometastatic disease. For local control, surgery remains the most efficient treatment, but the extent of the resection of macroscopically non-involved tissue, and as consequence, resulting dysfunction, can be reduced by properly planned postoperative radiotherapy and chemotherapy. Moreover, surgery may be easier, following preoperative radiotherapy or chemotherapy, which may also allow secondary excision of a primarily inoperable tumor. For the treatment of the micrometastatic disease, the efficacy of adjuvant chemotherapy has to be confirmed by further studies; some results published to date are encouraging. Thus, treatment of soft-tissue sarcomas remains difficult, but important advances are to be expected in the next few years. A multidisciplinary approach is necessary, involving not only surgeons, radiotherapists and medical oncologists, but also radiologists and pathologists.