Soft Tissue Sarcoma

Sarcoma is cancer of the connective tissue such as muscle, cartilage, blood vessels, nerves and bones. Soft tissue (non-bone) sarcomas are rare, but they can occur in many parts of the body such as muscle or fat of the extremities or the trunk. They can also occur in the abdomen, pelvis or chest. There are many types of soft tissue sarcomas, but most are treated in the same way. Some common soft tissue sarcomas include fibrosarcoma, liposarcoma, malignant fibrous histiocytoma, rhabdomyosarcoma and synovial sarcoma.


Diagnosis

Patients often discover soft tissue sarcoma as a lump or hard mass. They often have no pain or other symptoms. A doctor should examine any lump or mass that does not go away within a few days.

Specialists use imaging studies such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) to evaluate the suspected tumor. Other imaging techniques that may be used include a chest CT, a bone scan and positron emission tomography (PET). These images are helpful in evaluating areas to which cancer commonly spreads (metastasizes).

To diagnose soft tissue sarcoma, the doctor removes a small piece of the suspected tumor for examination (biopsy). A pathologist looks at the cells under a microscope to confirm their type.


Treatment

Soft tissue sarcomas are treated with surgery, chemotherapy and radiation. Usually a combination of these modalities offers the best chance to treat the disease successfully.

Soft tissue sarcomas occur more frequently in adults than in children and adolescents. About half of all cases can be successfully treated and cured. The cure rate for soft tissue sarcoma depends on such factors as:

• The patient's age and general health
• The type and grade of the sarcoma
• The size of the tumor at diagnosis
• The tumor's location in the body
• Whether the sarcoma has spread (metastasized) to other parts of the body

Surgery
Surgery may sometimes be needed to obtain tissue for diagnosis as well as to remove the tumor. Chemotherapy and radiation may be given to improve likelihood that the tumor has been successfully treated.

Chemotherapy
During chemotherapy, a combination of cancer-fighting drugs attacks soft tissue sarcoma cells wherever they may be in the body.

Radiation
Prior to surgery, radiation oncologists may apply high-energy external beam radiation to tissues containing soft tissue sarcoma prior to surgery to try to shrink tumors and kill cancer cells. Depending upon the tumor's size, shape and location, they treat tumors using 3-D conformal radiation therapy or intensity modulated radiation therapy, a highly precise technology. After removal of the tumor, intraoperative radiation therapy (IORT) may be given. IORT may involve placement of hollow tubes for insertion of brachytherapy seeds several days after the surgery. Radiation, when used with surgery, may improve control of the tumor at the initial site for most soft tissue sarcoma patients.