Soft Tissue Sarcoma: Systemic Approaches & Chemotherapy

For some types of sarcoma, we recommend first administering chemotherapy to shrink the tumor, followed by surgery to remove the tumor and postsurgical (adjuvant) chemotherapy to kill any remaining cancer cells. Unlike surgery, which is directed toward a specific area of the body, chemotherapy travels through the bloodstream to all locations. For that reason, chemotherapy is called systemic treatment. It may be given orally or through an infusion in a vein.

At Memorial Sloan Kettering we typically base treatment recommendations on the subtype of sarcoma that you have. Many subtypes respond to standard chemotherapy agents. For subtypes that are often resistant to standard chemotherapies, we may discuss new therapy options available to you though participation in one of our clinical trials.

Treatment given prior to surgery is called neoadjuvant therapy. For sarcoma subtypes such as rhabdomyosarcoma and Ewing sarcoma, we often recommend neoadjuvant chemotherapy to shrink the tumor. This may permit the surgeon to perform a less extensive operation.

For certain subtypes, extended courses of chemotherapy are provided after surgery to produce the best outcome.

Our expert specialists can guide patients in determining whether systemic therapy is needed before or after surgery.

Chemotherapy for Recurrent or Metastatic Disease

Sometimes sarcoma recurs (returns) after initial treatment. It can also spread to distant areas of the body, a process known as metastasis. When patients have metastatic disease that cannot be removed surgically, systemic therapies may be recommended. Your medical oncologist will provide treatment while continuing to assess your ability to have successful surgery.

In people who do not respond to chemotherapy, our doctors may recommend enrollment in a clinical trial testing new investigative treatments.