What Are Soft Tissue Sarcomas?
Soft tissue sarcomas (STS) are rare malignant tumours arising from mesenchymal tissue (muscle, fat, fibrous tissue, vessels, nerves). Over 50 histological subtypes exist. They account for less than 1% of all adult malignancies but represent a significant oncological challenge due to their heterogeneity and the technical demands of surgery.
Prognostic Factors
Histological grade (FNCLCC): The most important prognostic factor. Grade 3 tumours have significantly worse prognosis than grade 1. Tumour size: Tumours >5 cm have higher metastatic risk. Location: Retroperitoneal sarcomas have worse outcomes than extremity sarcomas due to margin constraints. Surgical margins: R0 resection (clear margins) is the primary treatment goal and the most important modifiable prognostic factor. Histological subtype: Liposarcoma, leiomyosarcoma, synovial sarcoma, MPNST and others have distinct behaviours. Depth: Deep tumours have worse prognosis than superficial ones.
Survival Data
Overall 5-year survival for localised STS is approximately 65–80%. For retroperitoneal sarcomas specifically, 5-year survival ranges from 40–60% at specialised centres. High-grade extremity sarcomas have 5-year survival of 50–70%. Dedifferentiated liposarcoma and leiomyosarcoma of the retroperitoneum have distinct recurrence patterns requiring long-term follow-up.
The Importance of Specialised Surgery
Surgery at a specialised sarcoma centre with an experienced multidisciplinary team is associated with significantly better survival and lower local recurrence rates. Referral to a high-volume centre before the first surgery is strongly recommended — inadequate initial resection (intralesional margins) worsens prognosis even after re-excision.
Do you have a sarcoma diagnosis? At Quenet Torrent Institute our team specialises in complex sarcoma surgery. Request a specialised consultation or second opinion.