SURGERY FOR SOFT-TISSUE SARCOMAS (EXCEPT FOR RETROPERITONEAL SITES)

The place of surgery in the treatment of soft-tissue sarcoma is define d in the light of a review of the recent litterature. Usual treatment combines conservative surgery and radiotherapy. The essential risk fac tor of local recurrence is the quality of surgical resection, defined by the definitve resection margins. The addition of radiotherapy after inadequate surgery can improve local control, but cannot ensure that obtained after adequate surgery. Some limited tumours can be treated b y surgery alone, but radiotherapy remains essential in more advanced t umours. Under these conditions, local recurrence rates after surgery a lone, surgery and systematic radiotherapy and surgery with radiotherap y, as required are 27%, 28% and 30% respectively. The development of a local recurrence appears to affect survival in tumour with a good ini tial prognosis, early recurrence determining unfavourable outcome. Ser ious postoperative morbidity is observed in 14% of the cases and is re sponsible for delayed treatment and functional disorders. The use of m uscle flaps to fill the surgical defects can reduce these complication s. Evaluation of the functional results must be based on predefined ob jective criteria.