Soft tissue sarcomas can affect any part of the body. The most frequent location is on limbs, accounting for about half of all diagnoses, although most are on legs. A significant proportion of cases are within the body - in the abdominal space or behind the retroperitoneum.
The first objective for every patient is an accurate diagnosis. It is becoming less common than it once was for surgery to be undertaken before a full diagnosis is achieved but it can still happen. In some cases of abdominal/retroperitoneal tumours this can be preferable.
Good surgery can be a cure. The surgeon will look to achieve a 'wide margin' of disease-free tissue around the lump when he cuts it out. These margins will be checked in the pathology laboratory. A good clear margin of a few millimetres on every side of the tumour is the objective. If gaining clear margins is difficult it is probable that a course of radiotherapy will be proposed.
Although no longer common, amputation may be the surest way to remove the cancer when in a leg or arm. Limb salvage techniques are improving all the time but large tumours in awkward locations can make that approach impracticable.
The aim is to ensure that the patient is free of any evidence of the disease when initial treatment finishes.
Sarcomas, however, do tend to recur so careful monitoring is important, certainly for the first two years following surgery. Monitoring will include a clinical examination, a chest x-ray (in some circumstances CT scans), and other simple tests, usually three/four monthly for a period, then six monthly, then annually.
There is plenty of evidence that treatment at a specialist treatment centre delivers the best results for patients. In the past initial surgery has often been at the hands of a surgeon at a local hospital, who may only see a few sarcomas a year.
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