SARCOMA MANAGEMENT BASED ON A STANDARDIZED TNM CLASSIFICATION

The proper management of soft tissue sarcomas, that offering the highest cure rate while attempting limb sparing should the extremities be involved, requires a standard approach best achieved with the TNM classification. Such staging of the sarcomatous lesion is based primarily on the histologic grade, followed by size and finally histologic classification. The definitive approach is surgical, with muscle group dissection employed at all sites, including the extremities, trunk, and head and neck region. Radiation therapy alone or in combination with chemotherapy improves survival in all high-grade lesions at risk for recurrence. Evaluation of the primary and recurrent lesion by computed tomography, magnetic resonance when necessary, and angiography offers the best approach for evaluation of the lesion in treatment planning.