Intra-arterial Chemotherapy, Preoperative and Postoperative Radiotherapy, and Surgery for Primary “Unresectable” High-Grade Soft Tissue Sarcomas of the Extremities

The prognosis of soft tissue sarcomas of the extremities is determined by the location, size, histology, stage, and prior treatment of the tumor. Prevention of local recurrence and limb saving are two major considerations in the treatment of extremity sarcomas. Without adequate surgery, the risk of local recurrence is 30%–50%. Extensive surgery, compartment excision when possible, combined with 50–60 Gy postoperative external-beam radiotherapy (EBRT) in the case of marginal resections has reduced the local failure rate to 5%–20% [5]. Is it possible to increase the limb-saving rate in high-grade soft tissue sarcomas of the extremities without increasing the local failure rate or decreasing disease-free survival?