6.3 Treatment
The pathway for and manageing patients with recurrent or metastatic sarcoma is a continuum of care within the multidisciplinary team and recapitulates section 4.
Treatment will depend on the location and extent of disease, timing of recurrence, previous management and the patient’s preferences.
Participation in research and/or clinical trials should be encouraged where available and appropriate.
The standard approach to local recurrence parallels the approach to primary local disease, although more often resort to preoperative or postoperative radiation therapy and/or chemotherapy, if not previously carried out.
In the case of isolated lung metastases, treatment is primarily surgical where complete removal of all metastases should be attempted (ESMO 2014a).
Palliative radiation therapy or chemotherapy may be considered for inoperable metastases (ESMO 2014a).
A number of targeted therapies have shown promising results in patients with certain histological types of advanced or metastatic soft tissue sarcoma (NCCN 2016a). The role of chemotherapy for recurrent Ewing’s sarcoma and osteosarcoma should follow protocolised treatment following multidisciplinary team discussion.
