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European Instructional Lectures pp 49–70Cite as

Surgery for Soft Tissue Sarcomas

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Part of the book series: European Instructional Lectures ((EICL,volume 13))

Abstract

Soft-tissue sarcomas are rare tumours of extreme heterogeneity. The degree of malignancy, the dimensions, the spontaneous necrosis and vascular invasion are important prognostic factors. Surgery, curative in more than 90 % of cases, is the main therapy. Obtaining adequate surgical margins (wide or radical) is essential. An important surgical aggressiveness however requires more complex reconstructions (free flaps, motor units transplants, nerves and tendons grafts etc.). Resection margins are must be adequate or if not, the use of radiotherapy will improve local control. The effect of radiotherapy does not differ significantly whether it is used pre- or post-operatively. The first, however, most frequently leads to local complications. Interstitial brachytherapy and intra-operative radiotherapy have special advantages. Currently, with surgery combined with radiation therapy, the risk of local recurrence is less than 10 %. Loco-regional treatment (infusion of hyperthermia with TNF, neo-adjuvant chemotherapy, etc.) are reserved for non-operable patients and may produce a reduction in the neoplastic mass which allows conservative surgery in 85 % of cases.

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Authors and Affiliations

  1. Department of Orthopaedic and Traumatology, Referring Centre for Orthopaedic Oncology and Reconstructive Surgery, Policlinico di Careggi, Largo Palagi 1, Florence, Italy

    Rodolfo Capanna MD & Filippo Frenos MD

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  1. Rodolfo Capanna MD
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  2. Filippo Frenos MD
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Correspondence to Rodolfo Capanna MD .

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  1. Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, Middlesex, United Kingdom

    George Bentley

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Capanna, R., Frenos, F. (2013). Surgery for Soft Tissue Sarcomas. In: Bentley, G. (eds) European Instructional Lectures. European Instructional Lectures, vol 13. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36149-4_5

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  • DOI: https://doi.org/10.1007/978-3-642-36149-4_5

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