Is Adult Soft Tissue Sarcoma Curable?

Adult soft tissue sarcoma is more able to be cured with surgical treatment when it is found early and is still localized.

Adult soft tissue sarcoma is an uncommon type of cancer that occurs when the cells in the soft tissues of the body grow out of control.

• Soft tissue sarcomas can develop in soft tissues such as fat, muscle, nerves, fibrous tissues such as tendons, blood vessels, lymph vessels, or deep skin tissues. They can occur in any part of the body.
• Sarcomas are not common, and some are very rare and others can be very deadly. 
• Adult soft tissue sarcomas commonly develop in the head, neck, arms, legs, trunk, abdomen, and retroperitoneum, though they can occur anywhere in the body. 
• There are many types of sarcomas, and not all of them are cancerous, however, when the word sarcoma is part of the name of a disease, it means the tumor is cancerous (malignant).

Adult soft tissue sarcoma is more able to be cured with surgical treatment when it is found early and is still localized. 

• About 60% of sarcomas are found as a localized sarcoma
  • The five-year survival rate for localized sarcoma is 81%
• About 19% of sarcomas are found in a locally advanced stage
  • The five-year survival rate for locally advanced sarcoma is 56%
• About 15% of sarcomas are found in a metastatic stage
  • The five-year survival rate for metastatic sarcoma is 15%

Treatments for adult soft tissue sarcoma can include one or more of the following:

• Surgery 
  • This most common treatment 
  • The goal of surgery is to remove the entire tumor along with at least 1 to 2 cm (less than an inch) of the normal tissue around it (wide margins)
  • Wide local excision 
  • Amputation
  • Limb-sparing surgery
  • Lymph node dissection (lymphadenectomy)
  • Mohs microsurgery, in which the tumor is cut from the skin in thin layers
  • Chemotherapy (chemo), radiation, or both may be given before surgery (neoadjuvant treatment) or after surgery (adjuvant treatment)
• Radiation therapy 
  • External beam radiation
    • Most often used to treat sarcomas
    • Intensity modulated radiation therapy (IMRT) is used
  • Intraoperative radiation therapy (IORT)
    • One large dose of radiation given in the operating room after the tumor is removed but before the wound is closed
  • Brachytherapy (internal radiation therapy
    • Places small pellets (or seeds) of radioactive material in or near the cancer
  • Proton beam radiation (not widely available)
• Chemotherapy 
  • Dactinomycin (Cosmegen)
  • Doxorubicin (Adriamycin)
  • Eribulin (Halaven)
  • Imatinib mesylate (Gleevec)
  • Pazopanib mydrochloride
  • Tazemetostat mydrobromide
  • Trabectedin (Yondelis)
• Targeted drug therapy 
  • Pazopanib (Votrient)
  • Tazemetostat (Tazverik)
  • Regorafenib (Stivarga)
  • Sorafenib (Nexavar)
  • Sunitinib (Sutent)
  • Larotrectinib (Vitrakvi) (for tumors with an NTRK gene change)
  • Entrectinib (Rozlytrek) (for tumors with an NTRK gene change)
• Drug combinations
  • VAC: vincristine sulfate, dactinomycin, cyclophosphamide