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Diagnosis and management of distant recurrence in soft-tissue sarcomas.

Understanding of the patterns of, and treatments for, metastatic disease from soft-tissue sarcoma is of vital importance in caring for these patients. Metastasis can occur independently of adequate local control. When metastasis occurs, it usually causes no symptoms. Thus, all patients with malignant soft-tissue sarcomas must be followed with a careful surveillance regimen. When metastasis is discovered, the overriding goals of surgical treatment must be total resection of all tumor with the minimal loss of functional lung tissue. Multiple subsequent resections may be needed for recurrent metastasis but the goals remain the same. Postoperative chemotherapy may be of benefit in eradicating residual micrometastases. With ongoing research and the advent of more effective and better-tolerated adjuvant therapies, we should continue to make progress obtaining better cure rates and longer duration of survival for these patients.