Treatments for stages 2 and 3 soft tissue sarcoma
The following are treatment options for stages 2 and 3 (localized and high-grade) soft tissue sarcoma. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
Surgery is the main treatment for stage 2 and stage 3 soft tissue sarcomas. A wide local excision is done to remove the tumour along with some normal tissue around it (surgical margin). If needed, limb-sparing surgery can be used for soft tissue sarcoma in an arm or a leg.
Sometimes another surgery is done to remove more tissue if there are still cancer cells found around the tumour or there wasn’t enough normal tissue removed.
Amputation may be done to remove part or all of an arm or a leg. In rare cases, it is needed to make sure all of the cancer is removed.
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Radiation therapy is usually offered for stage 2 and stage 3 soft tissue sarcomas. External radiation therapy is most often used.
Radiation therapy can be given before surgery to help shrink a large tumour and make it easier to remove. It may also be given before surgery for tumours of the abdomen, trunk of the body or head and neck area because these tumours tend to be difficult to remove.
Radiation therapy may be given after surgery if there are still cancer cells found around the tumour (positive surgical margin) or there wasn’t enough normal tissue removed, especially when more surgery is not possible. This helps lower the risk of the cancer coming back (recurring).
If surgery can’t be done (the cancer is unresectable), radiation therapy may be used alone or with chemotherapy as well.
You may be offered chemotherapy for stage 2 and stage 3 soft tissue sarcomas. It is used to help lower the risk of the cancer coming back and prevent it from spreading. It is also used to help shrink the tumour before surgery.
Chemotherapy can be given before or after surgery. Doxorubicin is the standard chemotherapy drug used and it is usually given alone. It may be given in combination with ifosfamide (Ifex). Other chemotherapy drugs can be used if doxorubicin doesn’t work.
If surgery can’t be done, chemotherapy may be added to radiation therapy to control the growth of the tumour. Sometimes this treatment can make surgery possible.
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American Society of Clinical Oncology. Sarcoma, Soft Tissue. 2017: https://www.cancer.net/cancer-types/sarcoma-soft-tissue.
National Cancer Institute. Adult Soft Tissue SarcomaTreatment (PDQ®) Health Professional Version. 2018: https://www.cancer.gov/types/soft-tissue-sarcoma/hp/adult-soft-tissue-treatment-pdq.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Soft Tissue Sarcoma (Version 2.2018). https://www.nccn.org/professionals/physician_gls/default.aspx.
Penn Medicine. All About Soft Tissue Sarcoma. University of Pennsylvania; 2016: https://www.oncolink.org/cancers/sarcomas/sarcoma-soft-tissue/all-about-soft-tissue-sarcoma.
Singer S, Tap WD, Crago AM, O'Sullivan B . Soft tissue sarcoma. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health; 2015: 90:1253-1291.