Sarcomas are best treated by an experienced team of specialists in surgical oncology (often orthopedic oncologists in the case of bone tumors), radiation oncology, medical oncology and often physical medicine and rehabilitation .
The initial biopsy must be carefully planned to ensure that enough tissue is available for diagnosis, but also to allow for subsequent surgery. This is especially important with sarcomas involving arms or legs, where the appropriate biopsy can make limb-sparing surgery more effective.
Prognosis is affected by a patient's age, the size of the primary tumor , grade and stage, degree of lymphatic and blood vessel invasion, the duration of symptoms and the location of the tumor on the arm, leg or trunk. Unfavorable prognostic signs include age over 60, a tumor larger than 5 cm (2 in.), a high-grade tumor, spread to lymph nodes or distant sites, a deep rather than a superficial malignancy, and symptoms lasting less than one year.
Low-grade tumors can usually be cured by surgery alone. Higher grade sarcomas have more tendency to recur in the same area or metastasize and so are often treated with surgery, radiotherapy and/or chemotherapy .
Many of these tumors are treated by a combination of surgery, radiation therapy and sometimes chemotherapy to improve the possibility of cure. The prognosis for sarcomas involving the retroperitoneum (area in the back of the abdomen) is less favorable, since it is difficult to surgically resect all the tumor as well as to give higher-dosage radiotherapy.
