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Soft Tissue Sarcoma

Cancer arising in the Mesenchymal tissue (Connective Tissue), known as Sarcoma. And the sarcoma arising in the soft tissue, called Soft Tissue Sarcoma (STS).

So, it can arise from following tissue

1. Muscles – Rhabdomyosarcoma
2. Blood vessels – Angiosarcoma
3. Nerves – Malignant peripheral nerve sheath tumour (MPNST)
4. Fat – Liposarcoma
5. Joint tissue – Synovial sarcoma, chondrosarcoma
6. Ligament and tendon – Fibrosarcoma

Location: It can arise anywhere in the body. Most common location is extremity in which thigh is the most common site. Retroperitoneal area is the 2^nd most common site.

Age: Age is no bar for sarcomas, some sarcoma can happen in young age and even in children.

Symptoms of Sarcoma:

1. A new lump
2. Pain in existing lump
3. Sudden increase in size of pre-existing lump
4. Lump of size more than 5 cm
5. Difficulty in normal movement
6. Fatigue
7. Unintended weight loss

Risk Factors: Most of the patients don’t have any risk factors, while some risk factors are:

1. Exposure to radiation
2. Genetic syndrome like NF1 etc.
3. Chemical exposure
4. Pre-existing swelling like lymphedema

Can Soft Tissue Sarcoma spread?

Yes. It can spread to Lungs, Lymph nodes and vital organs.

Diagnosis

Correct diagnosis is the most important part of management. As there about 50 types of histologically different types of STS. Prognosis and management plan depends on the histology.

Biopsy will be done to diagnose correct histology. Biopsy should always be done by Sarcoma Specialist Surgeon. Wrong Biopsy may lead to spread of cancer.

Evaluation at a cancer center that treats large number of sarcoma patients and have specialized sarcoma management team improves chances of correct diagnosis and treatment and reduces chances of relapse.

Once diagnosis is confirmed, staging work-up will be done to rule out spread to other organs, in the form of CT chest, USG of draining lymph node or PET-CT.

Treatment

Sarcoma specialist will tell you different treatment options. These Options were advised depending on the various factors like stage, grade, and histology. Having appropriate knowledge about them will help you make the right decision.

1. Surgery: It is the main treatment for Sarcoma. Type of surgery like Limb Salvage or Amputation will depend on location and extent of tumor.
2. Chemotherapy: It is the cytotoxic drug given to kill the cancer cells. Useful in certain type of sarcoma. Can be given before or after the surgery depending upon stage. Can be used as supportive treatment for improvement of quality of life.
3. Radiation Therapy: This mode of treatment given to reduce the chances of local relapse. In this high energy X-ray Beam given to kill cancer cells. Can be given before surgery to shrink the tumor. Or can be given after surgery to kill remaining cancer cells. It can be given as external beam radiation or as Brachytherapy.

Outcome of Sarcoma

Outcome of the treatment depend on several factors like stage of cancer, grade of tumour, size, location, adequacy of previous surgery, Biopsy scar and place whether treatment taken by sarcoma specialist or not.

• For Stage I, 5 yr survival is between 80% – 95%
• For Stage II/III, 5 yr Survival is between 60% – 70%
• For Stage IV, 5 yr Survival is usually < 40%