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Oncology / Haematology

Soft Tissue Sarcoma (STS)

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Soft Tissue Sarcoma (STS)
are a group of solid tumours that can develop anywhere in the body, and originate in soft tissues such as cartilage, fat, muscle, nerves, blood vessels, or deep skin tissues.1 Although soft tissue sarcomas can occur anywhere in the body, they most commonly occur (about 50 %) in the arms and legs. Other common sites include the gastrointestinal (GI) tract (25% of cases), retroperitoneum (15–20% of cases) and head and neck (approximately 9% of cases).2

STS account for approximately 1% of all adult cancers, with an estimated incidence averaging 4/100,000/year in Europe.3,4 The symptoms of STS are non-specific and vary according to the size and location of the tumour. Tumours usually manifest as a painless, gradually enlarging mass. Symptoms may arise due to increased pressure on adjacent organs and tissues, and the clinical picture varies according to the anatomical localisation.1

Progression of soft tissue sarcoma is divided into four stages (I-IV), with stages I and II having sub-stages of IA (tumor size ≤5 cm), IB (>5 cm), IIA (≤5 cm), and IIB (>5 cm). For all stages, the primary tumor may be either just beneath the skin or deeper in the muscle and connective tissue. Staging is identified by the likelihood of tumor growth and spread, with stage I tumours being likely to grow and spread slowly, and stage III tumours, likely to grow and spread quickly. Stages I and II soft tissue sarcomas are localized at the site of primary growth, whereas those of stages III and IV have spread to nearby lymph nodes, and more distant parts of the body, respectively. Surgery is the primary treatment for soft tissue sarcoma. Radiation therapy may also be added for high-grade, deep tumours and for select low-grade tumours that are closer to the surface. Chemotherapy may be started before or after surgery. The efficacy of chemotherapeutic agents varies, depending on tumor type.1

References:
  1. Clark MA, et al. Soft tissue sarcomas in adults. N Engl J Med 2005; 353:701-11.
  2. NCCN Clinical Practice Guidelines in Oncology 2010; www.nccn.org
  3. Jemal A, et al. Cancer statistics, 2007. CA Cancer J Clin 2007; 57:43-66.
  4. Casali PG, et al. Soft tissue sarcomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 2010; 21(suppl 5): v198-v203.
  5. American Joint Committee on Cancer 2017 (AJCC); www.cancerstaging.org