Surgery for soft tissue sarcomas

Sometimes surgery may have been done before the surgeon realised that the lump was a soft tissue sarcoma. Normally in this situation you will then be referred to a sarcoma specialist. Sarcoma specialists often treat other types of cancer as well as sarcoma.

The aim of most sarcoma surgery is to remove as much of the tumour as possible. Usually, an operation called a wide local excision is done. This means removing the cancer along with a border (margin) of healthy, cancer-free tissue all around it. The border of healthy tissue is removed to reduce the risk of the cancer coming back in that area.

It’s difficult to give general information about sarcoma surgery because the type of operation you have will depend on where in your body the sarcoma is. Many sarcomas are in the arm or leg, but they can grow anywhere. Your surgeon will discuss the operation with you in detail before any choice is made about your treatment.

Surgery to the chest or abdomen

Surgery is usually the main treatment for soft tissue sarcomas of the trunk (the chest and abdomen). The extent of the operation will depend on the exact position of the sarcoma in the body. Your doctor will discuss this fully with you before the operation.

After your operation, you will have a tube (drip) going into a vein in your arm. This will give you fluids and nutrients for 2-3 days until you can eat and drink properly. The nurses on the ward will then take the drip out. Your doctor will let you know when you can start to eat again.

Radiotherapy  |may also be used after operations for sarcomas in the chest or abdomen to try to make sure that any remaining cancer cells are destroyed.

Surgery to the arms or legs

Major improvements have been made in surgery for soft tissue sarcomas of the arms and legs over the past few years. In the past, it was usually necessary to remove the limb (amputation|) if cancer was found. A false limb (prosthesis) would then be made to replace the limb that had been removed. Amputation is still sometimes necessary, but it’s now usually possible to just remove the cancer and some of the tissue around it. This is known as limb-sparing surgery| and is done by using a combination of surgery, radiotherapy and chemotherapy|.

Plastic surgery

Depending on the size and position of your tumour, the surgeon may have to
remove a large area of tissue. This may mean that you need to have some reconstructive/cosmetic (plastic) surgery to repair the area. If this kind of surgery is needed it will be done at the same time as your operation.

The aim of plastic surgery is to make the area look and function as naturally as possible. The exact type of surgery you have will depend on where in your body the sarcoma is and how much tissue the surgeon needs to remove. If only a small area has been removed, the surgeon may be able to join the two edges together again. For larger areas a skin graft may be needed. This involves taking some skin from a different part of the body (known as the donor site) and using it to repair the operation site. Both sites will gradually heal over a few weeks after the operation.

Occasionally the surgeon needs to repair the operation site with a specialist technique using skin and tissue. This is known as a tissue flap and there are several different types. The surgeon will explain your operation to you and answer any questions you may have.