[Surgery of limb and trunk wall soft tissue sarcoma].
For this review of surgery in soft tissue sarcoma, we reviewed literature and added our personal experience. In front of a soft tissue tumour, the major objective is to think it could be a sarcoma. Diagnosis actually is made by core needle biopsies, but sometimes a surgical biopsy is needed. Surgical resection is better defined since ten years and distinguishes resection R0 (in sano), R1 (microscopic residual disease) and R2 (macroscopic residual disease). Quality of resection is determined collegially by confrontation of surgical and pathological reports according recommendations of the French Sarcoma Group (FSG). The risk of local recurrence depends on resection-type and tumour grade. With the help of the surgical classification from FSG, local prognosis is better understood and treatment can be adapted to individual tumours. In experienced hands, local recurrence can be pushed down to near 10 against 20% formerly. Severe complications after sarcoma surgery occur in 14% of cases. Functional outcome studies have benefited from new scoring systems, which complete each other. Isolated limb perfusion is a method that could save limbs in some desperate situations.


CONCLUSIONS
Due to rarity and treatment specifications, soft tissue sarcoma should be treated in specialised centres.
Stoeckle
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Service de chirurgie, Institut Bergonié, CRLCC Bordeaux, 229, cours de l'Argonne, 33076 Bordeaux cedex, France. stoeckle@bergonie.org
D005121:Extremities; D006801:Humans; D012509:Sarcoma / Q000175:diagnosis / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000601:surgery*; D035441:Thoracic Wall