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J Am Acad Orthop Surg, Vol 17, No 1, January 2009, 40-47.
© 2009 the American Academy of Orthopaedic Surgeons
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Soft-tissue Sarcoma

Nathan F. Gilbert, MD, Christopher P. Cannon, MD, Patrick P. Lin, MD and Valerae O. Lewis, MD

Dr. Gilbert is Orthopaedic Surgeon, Musculoskeletal Surgical Oncology, Baylor University Medical Center, Dallas, TX. Dr. Cannon is Assistant Professor, Department of Orthopaedic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX. Dr. Lin is Associate Professor, Department of Orthopaedic Oncology, The University of Texas M. D. Anderson Cancer Center. Dr. Lewis is Associate Professor, Department of Orthopaedic Oncology, The University of Texas M. D. Anderson Cancer Center.

Dr. Lin or a member of his immediate family has received research or institutional support from Pfizer. Dr. Lewis or a member of her immediate family has received research or institutional support from Stryker. None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Gilbert and Dr. Cannon.

Reprint requests: Dr. Cannon, Department of Orthopaedic Oncology, The University of Texas M. D. Anderson Cancer Center, Unit 408, PO Box 301402, Houston, TX 77230-1402.

Soft-tissue sarcomas are rare malignancies of mesodermal origin. Common sites of involvement include the extremities, trunk, retroperitoneum, and the head and neck. Soft-tissue sarcomas of the extremities and pelvis are the most relevant to the orthopaedic surgeon. The patient with extremity soft-tissue sarcoma typically presents with a painless, enlarging mass. Advanced imaging techniques and biopsy, which are best done at tertiary referral centers, usually confirm the diagnosis. Factors such as sarcoma size, location, grade, histologic subtype, and stage, as well as patient age and comorbidities, determine the specific approach to management and patient outcome. Limb-sparing surgical resection is the mainstay of treatment. Radiation is used for unresectable tumors and as a neoadjuvant or an adjuvant to resection. The use of chemotherapy is controversial, and no standardized protocol has been established.






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