Sarcomas of the Soft Tissues and Bone

Sarcomas comprise a heterogeneous group of malignant tumors that arise in the soft tissues or bone. Soft tissue sarcomas are derived from primitive mesenchymal cells such as muscle, connective tissue (tendons and synovial tissue), supportive tissue (fat and nerves), and vascular tissue (lymph and blood vessels). Most patients with bone sarcomas have micrometastatic disease at diagnosis as evidenced by a high percentage of patients who develop lung metastases following local control therapy (i.e., surgery and/or radiation) alone. Site and extent of disease, as well as therapeutic interventions with chemotherapy, radiation, and surgery all contribute to late sequelae in sarcoma patients. A majority of first‐line protocols utilize high cumulative doses of anthracyclines (i.e., doxorubicin), resulting in a lifelong risk of developing cardiomyopathy. Addition of a cardioprotectant, dexrazoxane, is now commonly used to decrease the risk of cardiac late effects.