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NCCN Guidelines for Patients


Soft Tissue Sarcoma, Version 1.2014


There is little research that shows what are the best

treatments for stage IV sarcomas. Thus, clinical trials

are the preferred treatment option. If you don’t join a

clinical trial, the general recommendations presented

next may help. General recommendations are divided

into those for stage IV confined to one organ and

widespread stage IV.

Chart 2.3.1

lists treatment options for stage IV

sarcomas that have spread to one organ and aren’t

too large. In these cases, local treatment may be used

to treat the primary tumor. Local treatment options are

the same as those listed for stage II and III.

There are five other options to consider. One option

is surgery to remove the metastases. This surgery

is called a metastasectomy. You may be given

chemotherapy, radiation therapy, or both either before

or after surgery. The other four options are ablation,

embolization, SBRT, and observation.

Chart 2.3.2

lists care after cancer treatment has

ended. You should receive rehabilitation if needed.

This may include occupational or physical therapy.

You should also start to have follow-up tests to check

if the cancer has returned. Getting follow-up tests

can help find cancer early. Cancer is more likely to

be cured if found early. Tests include medical history,

physical exam, and imaging of your chest. If the

cancer is likely to return, you may get imaging tests of

the site were the primary tumor was.

Chart 2.3.3

lists the treatment options for

widespread sarcoma. Treatment options depend on if

the cancer is or isn’t causing symptoms. If you have

no symptoms, observation is an option. Observation

is a period of regular testing for cancer growth so

treatment can be started if needed.

If you do have symptoms, you can receive palliative

care. Palliative care is also called supportive care.

Palliative care does not try to cure the cancer. It aims

to relieve your discomfort. Chemotherapy, radiation

therapy, and surgery may reduce cancer symptoms

by stopping or reducing tumor growth. Ablation,

embolization, and SBRT may also reduce symptoms.


Sarcomas in limbs, outer trunk, head, or neck Stage IV sarcoma