Commonest surgical procedure for soft tissue sarcoma
Soft Tissue SarcomaRare unusual neoplasm of soft tissuesM/C site: Extremity (lower >upper) > Trunk > Retroperitoneum >Head & NeckM/C type: Malignant fibrous histiocytoma>Liposarcoma> Leiomyosarcoma >Synol sarcoma >Malignant peripheral nerve sheath tumorMC pediatric soft tissue sarcoma: RhabdomyosarcomaHistopathological Type of STSExtremityRetroperitoneumVisceraMalignant fibrous histiocytoma > LiposarcomaLiposarcomaGISTPathologyDiagnosis of Soft tissue sarcomaSTS tends to grow along fascial planes, with the surrounding soft tissue compressed to form a pseudocapsule.Clinical behavior of STS is determined by: Anatomic location (depth), grade & sizeM/C route of spread in soft tissue sarcoma: HematogenousM/C site of metastasis: LungCore-cut or true-cut biopsy (CT or USG guided) is diagnosticIncisional biopsy is done if core-cut biopsy is non-diagnosticFNAC: To confirm or rule out presence of metastatic focus or local recurrenceMRI: IOC for assessing extremity STSCECT: IOC for assessing retroperitoneal sarcomaClinical featuresTreatmentM/C symptom of STS: Painless massSize at presentation is dependent on the location of tumor.Smaller tumors - distal extremitiesLarger tumors - proximal extremity & retroperitoneumAdequate excision + adjuvant radiotherapy with or without adjuvant chemotherapy.PrognosisBest prognostic factor of soft tissue sarcoma: GradingBest prognosis is seen in: ExtremitySTSMC cause of death in STS: Metastasis; 5-year survival rate for STS (all stages): 50-60%(Refer: Devita, Hellman, Rosenberg's Cancer Principles and Practice of Oncology, 9th edition, pg no: 1533-1552)
Marginal excision
Enucleation
Wide local excision
Compamental excision
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