Understanding Soft Tissue Sarcoma

(July 2009) - Soft tissue sarcoma is a type of cancer that forms in the body’s muscles, tendons, fat, blood vessels, lymph vessels, nerves, or tissues. It can also form in the gastrointestinal tract and a small percentage of these are called gastrointestinal stromal tumors (GISTs). GISTs can occur from the esophagus to the rectum but are most commonly found in the stomach and small intestine.

Soft tissue sarcoma is rare and accounts for about 1 percent of new cancer cases every year. There are approximately 10,000 new cases of soft tissue sarcoma diagnosed each year and 4,000 deaths from the disease. Soft tissue sarcomas occur with greater frequency in patients with various genetic disorders, although they also occur in people with no other predisposing conditions.

Diagnosing Soft Tissue Sarcoma

To plan the best treatment, it’s essential to get an adequate sample of the tumor through a core-needle biopsy or incisional biopsy. An experienced pathologist studies the tumor sample under a microscope and determines the type and grade of the tumor. Advanced imaging studies and image-guided biopsies may also be necessary to fully assess the cancer and create a treatment plan.

At the Curtis and Elizabeth Anderson Cancer Institute (ACI) at Memorial University Medical Center, all of the tumor information is reviewed by a multidisciplinary team of cancer specialists that includes medical, radiation, and surgical oncologists who wok with the patient and his/her family.

Treatment for Soft Tissue Sarcoma

A “combined modality” approach is often used to treat soft tissue sarcoma. This means that treatment may include a combination of surgery, chemotherapy, and/or radiation. The final treatment plan is based on the location, size, and type of the tumor, as well as the patient’s overall health.

For small, localized tumors in the arms or legs, we often perform surgery to remove the sarcoma. If it has not spread, surgery can cure the cancer. Larger tumors may require surgery along with chemotherapy and radiation. Reconstructive surgery may also be required to close a wound, maintain function, or improve the appearance of the extremity where the cancer was removed.

Retroperitoneal sarcomas (those located behind the abdomen, in the area near the kidneys) can be more challenging to treat. Generally, retroperitoneal sarcomas are discovered later, have a larger size, and have already spread into adjacent organs. The gold standard of effective treatment is the complete removal of the tumor and complete or partial removal of adjacent organs involved, followed by reconstruction to maintain functionality. This requires an experienced surgical team for optimal outcomes.

GISTs are best treated by surgically removing the affected area. We are also finding that some drugs (tyrosine kinase inhibitors and related biologic therapies) are very effective in the treatment of GISTs.

Metastatic disease, or soft tissue sarcoma that has metastasized (spread) to other parts of the body, can sometimes be removed with surgery as well. This depends on the location, size, and number of tumors, and the underlying health of the patient.

The ACI is the home of the most comprehensive and experienced team of cancer surgeons in southeast Georgia. Our surgeons were trained at some of the finest facilities in the nation and are recognized leaders in their field. Whether you’re seeking treatment or a second opinion, you can count on the surgical expertise at the ACI.

James Garber, M.D., is a surgical oncologist at ACI -- Surgical Associates. He specializes in esophageal, pancreas, liver, and endocrine surgery.  To request and appointment with Dr. Garber, call ACI – Surgical Associates at 912-350-2299.