6.3.2 Metastatic disease

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.