Welcome to the new Gustave Roussy website
A new website designed to offer you a simpler, clearer, and more intuitive experience. Patients, caregivers, healthcare professionals, and donors: find information, news, and services more easily.
Sarcomas
Director
Dr. Matthieu Faron
Contact
Phone: +33 (0)1 42 11 44 99
Email
Sarcomas are rare cancers that develop from the body’s supportive tissues, such as muscles, fat, blood vessels, nerves, deep tissues, or bones. They can occur in many parts of the body and include multiple subtypes, the diagnosis and treatment of which require specialized expertise.
Care at a specialized center as soon as a suspicion arises
Before any biopsy or procedure, a suspicious mass must be evaluated at a specialized center. Imaging, the biopsy approach, and surgery must be planned together to preserve treatment options.
Understanding the Disease
The term “sarcoma” does not refer to a single disease. It encompasses a highly diverse group of tumors, classified according to their tissue of origin, location, histopathological features, and molecular characteristics. Their progression and response to treatment vary greatly from one subtype to another.
-
Soft Tissues
Muscles, fat, fibrous tissue, blood vessels, nerves, and other supporting tissues.
-
Visceral organs
Sarcomas that develop in an organ or in the retroperitoneum, at the back of the abdomen.
-
Bones
Bone sarcomas, some of which are more common in children, adolescents, or young adults.
Types of Sarcomas
They can develop in a limb, the trunk, the head and neck, the abdomen, or the retroperitoneum. Their names depend on the type of cells and the characteristics observed under a microscope and through molecular analyses.
They originate in bone. They include, in particular, osteosarcomas, Ewing sarcomas, and chondrosarcomas. Their management requires expertise in oncology, imaging, pathology, and specialized orthopedic surgery.
Gastrointestinal stromal tumors, or GISTs, develop in the wall of the digestive tract. Their biology and treatments differ from those of many other sarcomas. Gustave Roussy also treats other rare tumors, including desmoid tumors and certain complex mesenchymal tumors.
Symptoms
Symptoms depend on the location. A soft tissue sarcoma may present as a mass that grows in size, sometimes without causing pain. A deep tumor in the abdomen or retroperitoneum may remain asymptomatic for a long time and then cause discomfort, pain, or symptoms related to organ compression.
An MRI is often used to evaluate a mass in a limb or the wall of the trunk. A CT scan is particularly useful for thoracic, abdominal, or retroperitoneal masses. The workup is tailored based on the location and suspected subtype.
A biopsy involves removing a small sample of the tumor before treatment. It is most often performed through the skin under radiological guidance. The access route is chosen in consultation with the surgical team, as the sample must be retrievable during the procedure if surgery is indicated.
Microscopic examination confirms the nature of the tumor and its grade. Given the rarity and diversity of sarcomas, a second opinion from an expert pathologist is essential. Certain genetic or molecular tests supplement the diagnosis and can guide treatment.
The Diagnostic Process
Clinical suspicion, appropriate imaging, consultation at a specialized center, guided biopsy, specialized pathological review, staging evaluation, followed by a multidisciplinary team meeting.
Coverage
Gustave Roussy is one of the coordinating centers of the NETSARC+ national reference network. Cases are discussed by sarcoma specialists during multidisciplinary team meetings, drawing on expertise in surgery, medical oncology, radiation therapy, imaging, and pathology.
The Institute treats soft tissue and visceral sarcomas, GISTs, desmoid tumors, and other rare tumors. For certain bone, thoracic, or cardiovascular locations, care is coordinated with partner institutions that have the necessary surgical expertise.
-
Expert Diagnosis
Pathological review and molecular analyses tailored to the subtype.
-
Consensus Decision
Discussion in the sarcoma multidisciplinary team meeting prior to any major treatment.
-
Coordinated Care Pathway
Care is organized at Gustave Roussy or with an expert partner, depending on the location.
Treatments
Treatment depends on the subtype, location, grade, extent of the disease, and the patient’s overall health. It may combine surgery, radiation therapy, and drug therapy. The sequence of treatments is determined before treatment begins.
For a localized, resectable sarcoma, the goal of surgery is to remove the tumor in a single piece with an adequate margin. The procedure is planned based on imaging and the biopsy path. The objective is to control the disease while preserving the function of the organ or limb as much as possible.
Radiation therapy may be recommended before or after surgery for certain sarcomas at risk of local recurrence. It can also be used to treat an inoperable lesion, a metastasis, or symptoms. The treatment fields and doses are tailored to minimize exposure to healthy tissue.
Chemotherapy is not routinely administered. It may be indicated before or after surgery in certain high-risk cases, or it may serve as the primary treatment for advanced disease. The choice of drugs depends, in particular, on the histological subtype and the clinical situation.
Some sarcomas exhibit biological abnormalities that can be targeted by a drug. This is particularly true of many GISTs. For other subtypes, targeted therapies, antibodies, or other approaches may be offered depending on available approvals or as part of a clinical trial.
For certain locally advanced sarcomas of the arm or leg, an isolated limb infusion may be considered at an experienced center. This technique delivers a high-concentration treatment locally to shrink the tumor and facilitate a limb-sparing treatment. It is not suitable for all cases.
In cases of advanced or metastatic disease
When the sarcoma has spread to distant sites or cannot be completely removed, the treatment strategy focuses on controlling the disease, relieving symptoms, and preserving quality of life. Drug therapies then play a central role. Surgery, radiation therapy, or a local treatment technique may be recommended for certain selected lesions.
Each subtype has its own strategy
In advanced sarcomas, the exact type of tumor and its molecular characteristics are critical. A treatment that is effective for a GIST, liposarcoma, or synovial sarcoma may not necessarily be appropriate for another subtype.
Research and Clinical Trials
The rarity of sarcomas makes collaborative research essential. Gustave Roussy participates in national and international clinical trials focusing on new drugs, targeted therapies, combination therapies, and strategies tailored to the molecular characteristics of the tumor.
A dynamic module for open-air testing
The available clinical trials are changing rapidly. For the new website, include a module linked to the clinical trial database rather than a static list of protocols or an outdated video presented as current news.
Appointments and Second Opinions
Useful Resources
-
Sarcoma Information
Information for patients and their loved ones
Frequently Asked Questions
No. Most soft-tissue masses are benign. However, a deep mass, or one that is persistent or growing in size, should be evaluated with imaging and a medical consultation before any intervention.
Because imaging, the biopsy procedure, and surgery are all interconnected. An unplanned biopsy or excision can complicate subsequent treatment. The specialized center organizes these steps in the correct order.
No. Surgery is the primary treatment for many localized sarcomas. Chemotherapy depends on the subtype, stage, and risk level. It is not routinely administered.
Yes, particularly to confirm the pathological diagnosis, discuss a complex surgery, or reassess a treatment strategy. Sarcomas are rare, and their management should be discussed within a specialized network.