Soft tissue sarcoma (STS) is a group of highly heterogeneous tumors of mesenchymal origin that have variable primary site locations and clinical behavior. Despite the broad diversity of STS, the standard of care involves surgical resection with or without radiation therapy (RT) to control local recurrence and systemic treatment in select cases. The complexities of STS require a critical understanding of the preoperative work-up process, surgical treatment, and postoperative management. Advanced imaging plays a vital role in the characterization of the soft tissue mass, preoperative biopsy planning, and disease staging. Surgical treatment prioritizes wide resection with negative margins, supported by newer margin classification systems for better prognosis. Further, advancements in surgical technique have enabled limb-salvage surgery to largely replace amputation in the management of these tumors. Additional surgical considerations, such as nerve preservation, vascular reconstruction, and complex tissue closure, further highlight the complexity of STS management. Lastly, postoperative follow-up is critical for the early detection of local or distant recurrences. For complex cases, such as unplanned excisions or invasive tumors, strategies like re-resection may be beneficial. Ongoing research into imaging, chemotherapy, and targeted therapies will further refine management strategies, especially in complex and recurrent cases. This review highlights the essential aspects of STS surgical management and underscores the need for coordinated, multidisciplinary care to enhance both survival and quality of life for affected patients.
软组织肉瘤（STS）是一组高度异质性的间叶源性肿瘤，其原发部位和临床行为具有多样性。尽管STS类型繁多，标准治疗方案仍以手术切除为主，部分病例辅以放疗以控制局部复发，并在特定情况下结合全身治疗。STS的复杂性要求对术前评估流程、手术治疗及术后管理有深入理解。先进影像学检查在软组织肿块特征分析、术前活检规划及疾病分期中发挥关键作用。手术治疗优先采用广泛切除并确保切缘阴性，新型切缘分类系统的应用有助于改善预后。此外，手术技术的进步使得保肢手术在肿瘤治疗中基本取代了截肢术。神经保留、血管重建及复杂组织闭合等额外手术考量进一步凸显了STS管理的复杂性。最后，术后随访对早期发现局部或远处复发至关重要。对于计划外切除或侵袭性肿瘤等复杂病例，再切除等策略可能具有临床价值。影像学、化疗及靶向治疗领域的持续研究将进一步完善治疗策略，特别是在复杂与复发病例中。本综述重点阐述STS外科治疗的核心要素，并强调通过协调多学科诊疗以提升患者生存率与生活质量的重要性。
肿瘤(癌症)患者之家