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Soft Tissue Sarcomas

  • Carlos Márcio Melo de Matos
  • Irapuan Teles de Araújo Filho
  • Marcos Vieira Fernandes
  • Dárcio Jânio Macedo Barbosa
  • Afrânio Tavares André
  • Geourgius Antoniou
  • Ramon Andrade De MelloEmail author
Chapter

Abstract

Soft tissue sarcomas (STS) are a heterogeneous group of malignant tumors of mesenchymal origin, accounting for less than 1% of all adult malignancies and 15% of pediatric cancers. The most common subtypes in adults are liposarcoma (which corresponds to 20% of all STS), leiomyosarcoma and undifferentiated pleomorphic sarcoma. Based on the pattern of dissemination and the risk of distant metastases a different imaging approach may be indicated for each STS subtype as a staging workup. However, a contrast enhanced chest computed tomography is recommended for all moderate or high grade STS as a baseline imaging. Surgery is the main treatment of localized STS. It is recommended that the resection of the primary tumor includes a 2 cm margin envelope of normal tissue surrounding the lesion. The indications for radiotherapy include: high grade tumors, large (>5 cm) proximal grade 2 tumors, head and neck STS, large or high grade retroperitoneal sarcomas, local recurrences or positive margins after surgery. Adjuvant chemotherapy is still not a consensus, but there are some histologies that are better responders, like: synovial sarcoma, myxoid or pleomorphic liposarcoma, leiomyosarcoma and undifferentiated pleomorphic sarcoma. Metastatic soft tissue sarcomas are basically treated with chemotherapy. However, as there is not any highly effective treatment for the metastatic disease, the prognostic factors for prolonged survival are more related to the tumor biology than to the treatment itself.

Keywords

Soft tissue sarcomas Liposarcomas Leiomyosarcomas Synovial sarcomas Limb salvage Radiotherapy Chemotherapy Metastasis 

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Carlos Márcio Melo de Matos
    • 1
  • Irapuan Teles de Araújo Filho
    • 1
  • Marcos Vieira Fernandes
    • 1
  • Dárcio Jânio Macedo Barbosa
    • 1
  • Afrânio Tavares André
    • 1
  • Geourgius Antoniou
    • 2
  • Ramon Andrade De Mello
    • 3
    • 4
    Email author
  1. 1.Division of SarcomaCeará Cancer InstituteFortalezaBrazil
  2. 2.Mount Vernon Cancer CentreLondonUK
  3. 3.Division of Medical OncologyFederal University of São Paulo (UNIFESP) & Hospital Israelita Albert EinsteinSão PauloBrazil
  4. 4.Department of Biomedical Sciences and MedicineUniversity of AlgarveFaroPortugal

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