Weichteilsarkome: Wie läuft die Operation ab?

Soft tissue sarcomas are a rare but diverse group of malignant tumors – and surgical treatment requires specialized experience. Professor Jakob vividly explains why early presentation to the sarcoma center is so important, how biopsies are performed correctly, and why surgical planning is crucial for treatment success. Learn what really matters in sarcoma surgery, what a so-called R0 resection means, and when additional radiation therapy or chemotherapy is necessary. The interview also addresses typical questions such as: When is surgery sufficient? When is radiation therapy used? What happens if the tumor cannot be completely removed? → Watch the video: All steps of a soft tissue sarcoma surgery explained clearly Soft tissue sarcomas (soft tissue tumors) are rare, often aggressive tumors that can arise in various parts of the body. In specialized sarcoma centers such as the Mannheim Sarcoma Center, experienced sarcoma surgeons like Prof. Jakob handle complex diagnostics and treatment. Even if a sarcoma is suspected, the surgeon performs a targeted biopsy using special techniques such as the coaxial needle to optimally prepare for the subsequent surgical approach. Professor Jakob emphasizes that sarcoma surgery requires a high level of expertise. The rash removal of a suspected hematoma can significantly worsen the prognosis. Therefore, if a soft tissue sarcoma is confirmed or even suspected, a specialized sarcoma center should be consulted. The surgical strategy depends on the tumor type (e.g., well-differentiated liposarcoma, myxofibrosarcoma) and grading (degree of aggressiveness). While surgery alone is often sufficient for less aggressive tumors, more aggressive sarcomas require a combination of surgery and adjuvant or neoadjuvant radiotherapy. Complete tumor resection with an R0 status is particularly important – this means that the tumor was removed with a healthy margin. For R1 or R2 resections (tumor at or within the resection margin), reoperation, radiation, or chemotherapy may be necessary. The pathologist carefully examines each surgical specimen and classifies the margin status. Location also plays a major role: Extremity sarcomas (e.g., of the arm or leg) can often be resected from a greater distance. Retroperitoneal sarcomas in the abdominal cavity require special planning because important organs and blood vessels are located close together. Head and neck sarcomas also pose significant surgical challenges. The decision between primary surgery, preoperative (neoadjuvant) radiation therapy, or adjuvant (postoperative) radiation depends on tumor biology, location, and individual risk factors, such as existing diabetes or impaired wound healing. After successful sarcoma surgery, structured follow-up care follows: Early mobilization Pain management Wound checks up to the third week Physical therapy and subsequent rehabilitation Lymphedema is a common problem after surgery on the extremities. However, the risk of lymphatic congestion can be reduced through consistent compression bandaging, compression stockings, and targeted lymphatic drainage. Overall, the goal of every sarcoma surgery is complete tumor clearance with maximum functional preservation – and this is always discussed individually with each patient at the Mannheim Sarcoma Center. → In the film, Prof. Jakob explains all the steps of sarcoma treatment: from diagnosis to surgery to follow-up care. With Prof. Dr. Jens Jakob (Mannheim University Hospital) and Karin Strube (Strube Foundation) A film by the Strube Foundation in cooperation with the German Sarcoma Foundation. Advice from patient representatives: Susanne Gutermuth and Odette Helbig. Coordination by Katja Winter 0:00 Introduction 0:43 Early contact with the sarcoma center is important 5:53 When surgery alone is sufficient 7:55 Aggressive tumors require combined therapies 8:43 Advantages and disadvantages of radiotherapy before surgery 12:46 Goal of surgery: tumor clearance and function preservation 15:40 R0, R1, R2, and RX 22:18 Making individual decisions together 23:26 Lymph nodes rarely play a role 24:32 The importance of tumor location 30:00 After surgery: wound healing, rehabilitation, and aftercare 32:33 Lymphedema: an underestimated problem