Weichteilsakrome. Aktuelle multimodale Diagnostik als Basis einer differenzierten operativen Therapie [Soft tissue sarcoma. Differentiating surgery based on modern multidisciplinary diagnosis]

Soft tissue sarcomas are characterized by their heterogeneity. With new diagnostic imaging techniques, low- and high-grade components of the tumor can be differentiated. Thus biopsies should be guided by imaging to assure representative specimens. Besides histopathology, the advent of chromosomal and gene expression analysis may allow more accurate classification in the near future. Gene expression profiling has already proven its value by finding new subclassifications in other tumor types. Furthermore, this technique is a promissing tool to predict the response of a tumor to neoadjuvant and adjuvant therapy. Up to now, response evaluation in neoadjuvant therapy is based on tumor size and not on vital tumor cells. Newer techniques (i.e., Magnetic-resonance-Spectroscopy, Molecular Imaging) can show the change of metabolism in neoadjuvant therapy and allow objective, comparative measurement of biological activity. The diagnostic of soft tissue sarcomas implies primarily a multidisciplinary approach for a stage associated therapy