Surgery with radiation therapy

High-grade localized soft tissue sarcomas have an increased potential for local recurrence and metastasis. For sarcomas of the extremities, local control comparable to that obtained with amputation may be achieved with limb-sparing surgery that involves wide local excision in combination with preoperative radiation therapy (preRT) or postoperative radiation therapy (PORT). Radiation decreases the risk of local recurrence but has not been shown to increase overall survival.[8-11]

A retrospective review that compared surgery with or without preRT for retroperitoneal sarcomas suggested that the addition of preRT was associated with improved local recurrence-free survival, but not disease-free survival.[12]