Surgery is the cornerstone of treatment for soft tissue sarcomas and often represents the only available therapeutic option. The standard surgical procedure is wide resection with negative margins, meaning the tumor must be resected with a layer of healthy tissue surrounding it. Negative margin resection is crucial for long-term local and systemic control. All efforts must therefore be made to obtain such surgical margins. The choice of combining radiation therapy with surgery to optimize local treatment depends on several factors, including tumor size, depth, histologic grade, and location. The use of radiation therapy reduces the rate of local recurrence in the years following the disease. Chemotherapy is rarely used for soft tissue sarcomas, with a few exceptions such as extraosseous Ewing sarcoma, rhabdomyosarcoma, synovial sarcoma, and certain subtypes of liposarcoma.
A Needle Biopsy is crucial for treatment planning. It determines the histologic type of sarcoma. Following histologic analysis and a patient's radiological assessment, the stage of the disease is determined, meaning its extent. Several diagnostic tests are performed depending on the type of sarcoma and include: a thoracic CT scan, an abdominopelvic CT scan, a bone scan, or sometimes a nuclear medicine PET scan.