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NCCN Guidelines for Patients

®

Soft Tissue Sarcoma, Version 1.2014

34

3.1 Treatment with surgery

Chart 3.1.1

maps the treatment options for

sarcomas that can be treated with surgery. Surgery

with or without IORT is an option whether you had a

biopsy or not. If you had a biopsy, radiation therapy

or chemotherapy before surgery is another option.

The goal is to remove all the cancer with cancer-free

surgical margins.

After surgery, your doctors will assess if you need

adjuvant treatment. Adjuvant treatment can help stop

the cancer from returning. Recommendations for

more treatment are based on whether cancer is at the

surgical margin.

3

Sarcomas in the inner trunk

Treatment with surgery

Chart 3.1.1 Treatment options

Testing

Neoadjuvant

treatment

Primary

treatment

Margin

status

Adjuvant

treatment

Radiation

therapy

Chemotherapy

Biopsy

No cancer

Cancer not seen

with the naked eye

Cancer seen

with the naked eye

No biopsy

Surgery ±

IORT

Surgery

Surgery

Surgery ±

IORT

Consider radiation

therapy if higher risk of

recurrence

Consider radiation

therapy if not received

before

Consider radiation

boost if received

radiation before

Consider surgery

Consider other

treatments if surgery

not possible

Chart 3.1.2 Care after treatment

Type of care

Schedule of care

• Physical exam and imaging of

abdomen and pelvis

Every 3–6 months for 2–3 years

° If good results, then repeat every 6 months for 2 years

° If good results, then repeat every year

• Consider imaging of chest