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Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Apr 24, 2020; 11(4): 180-189
Published online Apr 24, 2020. doi: 10.5306/wjco.v11.i4.180
Multidisciplinary treatment of soft tissue sarcomas: An update
Jorge Gómez, Panagiotis Tsagozis
Jorge Gómez, Department of Orthopedic Surgery, Clínica Universidad de Navarra, University of Navarra, Pamplona 31008, Spain
Panagiotis Tsagozis, Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm 17176, Sweden
Panagiotis Tsagozis, Muskuloskeletal Tumour Service, Karolinska University Hospital, Stockholm 17176, Sweden
Author contributions: Gómez J performed the literature review and analysis, and manuscript writing; Tsagozis P revised and edited the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jorge Gómez, MD, Surgeon, Surgical Oncologist, Department of Orthopedic Surgery, Clínica Universidad de Navarra, University of Navarra, Pío XII Avenue, Nº36, Pamplona 31008, Spain. jgomeza@unav.es
Received: December 28, 2019
Peer-review started: December 28, 2019
First decision: February 20, 2020
Revised: March 13, 2020
Accepted: March 22, 2020
Article in press: March 22, 2020
Published online: April 24, 2020
Processing time: 115 Days and 12.8 Hours
Abstract

Standard treatment for soft tissue sarcoma, based on complete surgical resection with or without adjuvant radiotherapy and chemotherapy, has not substantially changed during the last several decades. Nevertheless, recent advances have contributed to considerable improvement in the management of these patients; for example, new magnetic resonance imaging sequences such as diffusion-weighted imaging and magnetic resonance imaging radiomics can better assess tumor extension and even estimate its grade. Detection of circulating genetic material (liquid biopsy) and next-generation sequencing are powerful techniques for genetic analysis, which will increase our understanding of the underlying molecular mechanisms and may reveal potential therapeutic targets. The role of chemotherapy in non-metastatic disease is still controversial, and there is a need to identify patients who really benefit from this treatment. Novel chemotherapeutic regimens have entered clinical praxis and can change the outcome of patients with metastatic disease. Advances in radiotherapy have helped decrease local adverse effects and sustain good local control of the disease. The following report provides an updated view of the diagnosis, treatment, and future perspectives on the management of patients with soft tissue sarcomas.

Keywords: Soft tissue sarcomas; Multidisciplinary treatment; Surgery; Radiotherapy; Chemotherapy; Targeted therapy; Update treatment

Core tip: This report provides an updated view of the diagnosis, treatment, and future perspectives on the management of patients with soft tissue sarcomas. Recent advances include new magnetic resonance imaging sequences such as diffusion-weighted imaging and magnetic resonance imaging radiomics, which can better assess tumor extension and estimate tumor grade. Detection of circulating genetic material (liquid biopsy) and next-generation sequencing are powerful techniques that may reveal potential therapeutic targets. Novel chemotherapeutic regimens have entered clinical praxis and can change the outcome of patients with metastatic disease. Advances in radiotherapy have helped decrease local adverse effects and sustain good local disease control.