Soft Tissue Sarcoma: Surgery

Surgery is often part of the treatment for soft tissue sarcoma. Different kinds of surgery may be done. Which type you have depends on where the cancer is, how big it is, how much it has spread, and other factors.

Bone & Soft Tissue Cancer Sarcoma Treatment

Soft tissue sarcoma or bone and soft tissue cancer is rare cancer that begins in the tissues that connect, support, and surround other bodily structures. This includes muscle, fat, blood vessels, nerves, tendons, and the joint lining.

There are approximately 50 subgroups of soft tissue sarcoma. Some varieties mostly affect youngsters, while others primarily impact adults. These tumours can be difficult to diagnose since they can be mistaken for a variety of other growths. Soft tissue sarcoma can affect any area of the body, although it most commonly affects the arms and legs, as well as the belly.

Surgery is the primary treatment for soft tissue sarcoma. To make sure that the cancer does not return, it is important for surgeons to remove the entire tumor along with a small amount of healthy tissue around the tumor.

Soft tissue sarcoma can begin in many different parts of the body. The surgery that is right for you depends on the exact size and location of the tumor. For some people, surgery is all that is needed to cure the disease. Others may need radiation, chemotherapy, or other drugs before, during, or after the operation.

orthopedic-trauma
Minimally Invasive Surgery for Abdominal Sarcoma

A minimally invasive operation, such as laparoscopic or robotic surgery, may be an option for some people, especially those with gastrointestinal stromal tumors (GISTs). During a minimally invasive procedure, the doctor performs the same operation as in a traditional surgery but uses special tools that make several small incisions instead of one large one.

At Memorial Sloan Kettering, our soft tissue sarcoma surgeons are highly skilled in these techniques. We have a lot of experience in figuring out if such an approach might be right for you. The key consideration is always which technique is best for curing the cancer and giving you the best quality of life afterward. Although a minimally invasive approach can be a good option for many people, it is not right for everyone.

Limb-Sparing Surgery for Sarcoma in the Arms or Legs

Limb-sparing surgery is a treatment approach that allows people with soft tissue sarcoma in an arm or leg to avoid having the limb removed. Today, thanks to advances in treatment pioneered at MSK and other cancer centers, more than 95 percent of people with soft tissue sarcoma in an arm or leg do not need an amputation.

During a limb-sparing procedure, the surgeon removes the cancerous tissue, cartilage, and bone. Some people need radiation therapy, chemotherapy, or both to shrink the tumor before surgery. One of the advantages of coming to Memorial Sloan Kettering is that our surgeons know who to identify those patients who do not need more treatment other than surgery.

Plastic or Reconstructive Surgery for Sarcoma

Some people need plastic or reconstructive surgery to repair the area where the tumor was removed. This happens at the same time as the operation to remove the sarcoma.

Plastic or reconstructive surgery helps restore the body’s cosmetic appearance or physical function. It can also be used to replace skin and reconnect nerves and blood vessels so that you can get back to looking — and moving — like your normal self. What surgery you need depends on where in the body the sarcoma is and how much tissue your surgeon has to remove.

At Memorial Sloan Kettering, our plastic and reconstructive surgeons use the most-sophisticated techniques to minimize the side effects of surgery and help speed your recovery.

Surgery for Recurrent or Metastatic Sarcoma

If the sarcoma returns after your first cancer operation, it may be possible to cure it with another operation. Another option is to combine surgery with chemotherapy and radiation therapy. At Memorial Sloan Kettering, we make these treatment decisions with you. The right treatment depends on the specific circumstances of the disease. Sometimes we recommend surgery for tumors that have spread to other parts of the body (metastatic sarcoma).

If you are unable to have surgery, your doctor may recommend chemotherapy. Another option might be to enroll in a clinical trial that’s testing a new treatment approach for soft tissue sarcoma. There are studies of therapies designed to target genetic mutations that have been discovered in tumors and immunotherapies that can stimulate your immune system to attack cancer.

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Frequently Asked Questions

Most sarcomas have no known cause. Sarcomas can develop in children and adults for no clear reason. In some cases, sarcomas have been linked to past exposure to radiation, certain chemicals or viruses.

When you are referred to a sarcoma specialist, whether it’s an orthopedic oncologist or a surgical oncologist, the specialist will evaluate the size and location of the tumor as well as check for metastases. At the Kimmel Cancer Center, we run a variety of tests — from MRI and CT scans to bone scans and biopsies — to make sure we get the full picture of your condition.
Like most other cancers, a sarcoma may recur. When we perform sarcoma surgeries at Johns Hopkins, we aim for what we call a negative margin. This means cutting out the tumor and enough surrounding tissue to remove as many cancerous cells as possible. We may also use radiation treatment or chemotherapy to kill any remaining sarcoma cells. While this approach improves survival and life expectancy, it is possible that a sarcoma could return. Some sarcomas tend to reappear in the same spot, and others grow in new locations. Typically, if a sarcoma does come back, it happens within the first two to five years after surgery.
Once the surgery is finished, you will go through a period of recovery. It may include rehabilitation, physical therapy, occupational therapy and other care to manage the side effects of your treatment. Even after you are back to your everyday life, you should stick to the follow-up schedule recommended by your doctor to monitor your condition. This is called surveillance. This schedule is performed every three to six months, and it typically includes a CT scan, X-ray or another test depending on the type of sarcoma.