Multidisciplinary Treatment of Soft Tissue Sarcomas

The previous volume of this series on soft tissue sarcomas highlighted the importance of the multidisciplinary approach to treatment, the focus of which is continued in the present edition. Proper diagnosis and staging remain the cornerstone of the treatment strategy. Sophisticated histopathology techniques and growing consensus on grading systems have further increased the importance of the histopathologist in providing estimates of the prognosis of the patient as well as providing data for the planning of treatment strategy. The use of cytogenetics is relatively new in this field. This might enable the distinction of subgroups in specific histological tumor types. Furthermore, molecular biological studies not only help to reveal inherited predispositions and details in oncogenesis in tumor development, but they may also provide additional predictive factors for tumor behavior. Further data on treatment strategy will be provided by diagnostic imaging, a field in which the role of magnetic resonance imaging is rapidly developing. As far as actual treatment is concerned, surgery still provides the major chance for cure. In view of the endeavor to be as sparing as possible, the addition of radiotherapy to surgery is of utmost importance. Usually radiotherapy is given after surgery, but the optimal sequence of the two modalities still needs to be defined. The combined use of surgery with radiotherapy and/or chemotherapy does have an impact on wound healing.

The previous volume of this series on soft tissue sarcomas highlighted the importance of the multidisciplinary approach to treatment, the focus of which is continued in the present edition. Proper diagnosis and staging remain the cornerstone of the treatment strategy. Sophisticated histopathology techniques and growing consensus on grading systems have further increased the importance of the histopathologist in providing estimates of the prognosis of the patient as well as providing data for the planning of treatment strategy. The use of cytogenetics is relatively new in this field. This might enable the distinction of subgroups in specific histological tumor types. Furthermore, molecular biological studies not only help to reveal inherited predispositions and details in oncogenesis in tumor development, but they may also provide additional predictive factors for tumor behavior. Further data on treatment strategy will be provided by diagnostic imaging, a field in which the role of magnetic resonance imaging is rapidly developing. As far as actual treatment is concerned, surgery still provides the major chance for cure. In view of the endeavor to be as sparing as possible, the addition of radiotherapy to surgery is of utmost importance. Usually radiotherapy is given after surgery, but the optimal sequence of the two modalities still needs to be defined. The combined use of surgery with radiotherapy and/or chemotherapy does have an impact on wound healing.