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2.4 Recurrence treatment

Sarcoma may return as local disease. In this case,

the cancer should be treated by its stage as described

on pages 18 to 23. However, the return of sarcoma in

distant sites should be treated as described below.

Chart 2.4.1

lists the treatment options for a

recurrence that is metastatic disease. Options are

listed by the extent of the recurrence. First, sarcoma

may return as a small tumor within one organ. In this

case, surgery to remove the tumor is an option. You

may receive chemotherapy, radiation therapy, or both

either before or after surgery. Other options include

ablation, embolization, or SBRT.

The second list of treatment options is recurrences

within a confined area. The cancer may be in lymph

nodes that are near to where the cancer started. For

confined disease, options include surgery to remove

the lymph nodes with cancer. Surgery may also

be done to remove other tumors. You may receive

chemotherapy, radiation therapy, or both with the

surgery. The last option is SBRT.

NCCN Guidelines for Patients

®

Soft Tissue Sarcoma, Version 1.2014

26

2

Sarcomas in limbs, outer trunk, head, or neck Recurrence treatment

Chart 2.4.1 Distant recurrences

Cancer spread

Treatment options

Tumor in one organ and

it’s not large

• Surgery to remove metastases ± chemotherapy, radiation, or both

before or after surgery

• Ablation

• Embolization

• SBRT

Confined area

• Lymph node surgery ± chemotherapy, radiation, or both

• Surgery to remove metastases ± chemotherapy, radiation, or both

before or after surgery

• SBRT

Widespread

• Palliative chemotherapy

• Palliative radiation therapy

• Palliative surgery

• Observation if no symptoms

• Supportive care

• Ablation

• Embolization

• SBRT