Approaches to local salvage of soft tissue sarcoma after primary site failure.

Improvements in pretreatment evaluation and the wider application of specialized multidisciplinary care have substantially reduced the risk of local recurrence for patients with soft tissue sarcomas arising at any site, and the recurrences that are still seen are often those that are most difficult to manage effectively. The management strategy for an isolated local recurrence of soft tissue sarcoma is usually similar to that used for primary disease. With appropriate pretreatment evaluation and salvage therapy that includes a multidisciplinary approach, most patients with local recurrence can expect local disease control and a good functional outcome. The development of effective management of a local recurrence is often a complex problem. The necessary decisions are influenced by the tumor location, disease extent, and previous local therapy. The need for specialized care is stressed. Patient evaluation, management strategies, and expected outcome for various clinical scenarios are discussed.