Guidelines for the Management of Soft Tissue Sarcomas

Table 3

S uggested managment of extremity STS - adapted from ESMO guidance.

Adultsoft tissue sarcoma	Standard	Individualized	Investigational
Extremities or superficial trunk
Primary, low-grade, superficial	Surgery: wide excision
Primary, low-grade, deep and $\le$5 cm	Surgery: wide excision
Primary, low-grade, deep and $>$5 cm	Surgery: wide excision $\pm$ adjuvant radiation therapy
Primary, high-grade, superficial	Surgery: wide excision
Primary, high-grade, deep, $\le$5 cm	Surgery: wide excision	Surgery: wide excision $+$ adjuvant radiation therapy OR compartmental resection
Primary, high-grade, deep, $>$5 cm	Surgery: wide excision $+$ adjuvant radiation therapy (pre and/OR post)	Surgery: wide excision $+$ adjuvant radiation therapy (pre and/OR post) $+$ Discussion of adjuvant Chemotherapy	Neoadjuvant chemotherapy $\pm$ postoperative chemotherapy followed by Wide surgical excision $+$ adjuvant postoperative (or preoperative) radiation therapy
	Compartmental resection	Compartmental resection $+$ Discussion of adjuvant Chemotherapy
Local recurrence, low-grade	Surgery: wide excision $+$ adjuvant radiation therapy (pre and/OR post)	Surgery: wide excision	Isolated limb perfusion
Local recurrence, high-grade	Surgery: wide excision $+$ adjuvant radiation therapy	Surgery: wide excision $+$ Adjuvant Radiation therapy $+$ Discussion of Adjuvant Chemotherapy	Isolated limb perfusion
	Surgery: compartmental resection	Surgery: compartmental resection $+$ Discussion of Adjuvant Chemotherapy