Types of surgery for soft tissue sarcoma

Surgery is the main treatment for most types of soft tissue sarcoma.

Surgery for sarcoma is a very specialised treatment. A trained and highly specialised surgeon in this area will do your operation.

Surgery to the chest, abdomen or pelvis

It’s difficult to give general information about sarcoma surgery. The type of operation you have depends on where in your body the sarcoma is. Many sarcomas are in the arm or leg. 

Retroperitoneal sarcomas grow in the deeper tummy (abdomen) area. Surgery to remove them is often a big operation.

The aim of most surgery is to completely remove the cancer. The most common operation for this is a wide local excision. This means removing the cancer with a border of healthy tissue around it. Removing a border of healthy tissue with no cancer cells lowers the risk of the sarcoma coming back. 

For specific information about your operation, talk to your surgeon or specialist nurse. They can explain the aim of your surgery and what this will involve. It can help to make a list of any questions you have and take these to your appointment.

Surgery to an arm or leg (limb)

Your surgeon might be able to remove the cancer without removing the affected limb. This is called limb sparing or limb salvaging surgery. 

Sometimes, the only possible treatment is to remove the limb or part of the limb in which the sarcoma is growing. Removing all or part of a limb is called an amputation. You might need to have an amputation rather than limb sparing surgery if:

• the cancer has grown into the major nerves and blood vessels around it
• the position of the tumour means that limb sparing surgery is not possible
• it is not possible to completely remove the cancer with limb sparing surgery

Your surgeon might recommend you have an amputation if the sarcoma comes back after limb sparing surgery.

Plastic surgery

During some operations for soft tissue sarcoma the surgeon may need to remove a large area of tissue. So you might need some plastic surgery to repair the area. You have this at the same time as your sarcoma operation. 

Plastic surgery aims to give you a result that is as natural looking as possible. It also tries to keep normal functioning or movement in that area of the body.

Surgery for sarcoma that has spread

When sarcoma spreads to another part of the body, it is called secondary (metastatic) cancer. The most common place for sarcoma to spread is the lungs or liver.

It is sometimes possible to operate to remove areas of sarcoma in the lung or liver. But this is only possible for a small number of people who have a limited number of secondary cancers.

There are some specialist types of surgery. Your doctor might recommend one of these if you have spread to the lungs or liver. One type, laser therapy, uses a very high powered beam of light to heat up and destroy cancer cells. This can be used to treat small metastases up to 5 cm in size.

Specialist surgery aims to kill cancer cells in the lungs or liver, without causing too much bleeding or other side effects. These types of surgery are not suitable for everyone.

If your sarcoma has spread to other parts of the body other than the liver or lungs your doctor is unlikely to offer surgery. They might suggest chemotherapy or radiotherapy instead.