
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Liposarcoma surgery
Introduction
Overview
Overview
The predominant therapy for liposarcoma is surgical resection. Adjunctive chemotherapy and radiation may be required.
Surgery
Surgery
- Surgery is the key treatment of non-metastasized liposarcoma.
- Tumor along with a wide margin of healthy tissue is removed to ensure that only healthy tissue is retained.
- Stage 1 liposarcomas of limbs, trunk, head and neck are treated with surgery.
- Stage 2 and 3 may require radiation and chemotherapy along with surgery.
- Following is a classification for surgical resection:[1]
| Surgical resection | Proceedure |
|---|---|
| Intraleisional | Curettage, partial tumor removal |
| Marginal | May leave microscopic tumor behind |
| Wide | Remove tumor and surrounding cuff of tissue |
| Radical | Remove entire compartment, includes amputation |
Treatment by Stage
Treatment of Stage 1 Sarcoma
- Primary treatment is surgery.
- If the margins are cut >1 cm sparing the fascia, “care” after surgery is the adjuvant treatment.
- “Care” includes the following.:
- Rehabilitation if needed
- Medical history and physical examination every 3 – 6 months for every 2 – 3 years
- Chest imaging every 6 – 12 months
- Tumor site imaging right after surgery and then at regular intervals of time
- If the margins are cut <1 cm with the fascia, for stage 1A consider radiation therapy and “care” after treatment and for stage 1B consider radiation therapy.
Treatment of Stage 2 and Stage 3 Sarcoma
- For stage 2A, radiation is given as neoadjuvant therapy followed by surgery as a primary treatment and then radiation boost as an adjuvant therapy.
- For stage 2B or 3, radiation/chemotherapy/chemoradiation are given as neoadjuvant therapy followed by surgery as a primary treatment and radiation boost or chemotherapy as an adjuvant therapy.
- For tumors which cannot be surgically resected, radiation therapy/chemoradiation/chemotherapy/isolated limb chemotherapy is given as primary treatment.
- It is followed by surgery if possible and radiation boost/chemotherapy as a follow up treatment option.
- If surgery is still not feasible, radiation/palliative chemotherapy or surgery/amputation/supportive care are the treatment options.
Treatment of Stage 4 Sarcoma
Confined Cancer Spread
| For confined cancer spread |
|---|
| Surgery, to remove metastatic lesions with chemotherapy and radiation before and after surgery |
| Ablation |
| Observation |
| Stereotactic Body Radiation Therapy (SBRT) |
| Embolization |
Widespread cancer
| For widespread cancer |
|---|
| Palliative chemotherapy |
| Palliative radiation therapy |
| Palliative surgery |
| Stereotactic Body Radiation Therapy (SBRT) |
| Embolization |
| Observation if asymptomatic |
| Ablation |
| Supportive care |
Recurrent Sarcoma in Distant Sites is Treated with the Following Options:
| Cancer spread | Treatment options |
|---|---|
| Tumor in one organ | Surgery with chemotherapy/radiation before and after surgery |
| Confined area |
|
| Widespread |    Palliative chemotherapy    Palliative radiation therapy    Palliative surgery    Stereotactic Body Radiation Therapy (SBR)    Embolization    Ablation |
References
References
- ↑ Enneking WF, Spanier SS, Goodman MA (1980). “A system for the surgical staging of musculoskeletal sarcoma”. Clin Orthop Relat Res (153): 106–20. PMID [ 7449206 [ Check
|pmid=value (help). - ↑ “NCCN”.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Â ; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
