The Ever-Evolving Landscape of Sarcomas: A 2022 Update on This Complex Family of Diseases

This issue of the Surgical Oncology Clinics of North America focuses on the management of sarcoma. As the title of the issue implies, sarcoma involves a wide array of heterogeneous mesenchymal neoplasms, including malignant fibrous histiocytoma, liposarcoma, leiomyosarcoma, synovial sarcoma, dermatofibrosarcoma protuberans, angiosarcoma, and rhabdomyosarcoma, among others. Typically classified on the basis of genetic alterations and light-microscopic examination of hematoxylin-eosin–stained tissue, the different histological and morphological characteristics serve to help identify the different sarcoma subtypes. In addition to histology, the prognosis of patients with sarcomas is also associated with grade, size, and location of the primary tumor. Over the last several decades, there has been increased understanding about the genetic mutations and specific cytogenetic changes associated with the various sarcoma subtypes. Treatment approaches to sarcoma have similarly evolved and are often complex and multidisciplinary in nature. In particular, approaches to the treatment of sarcoma may depend on multiple factors, including histological subtype, location, size, as well as whether the disease is primary/recurrent and/or local/distant in extent. Specifically, chemotherapy, radiotherapy, surgical resection, as well as targeted therapy may all have a role in the management of sarcoma. Given the complex and ever-evolving landscape of sarcoma treatment, I believe this current issue of Surgical Oncology Clinics of North America is very timely and will provide a much needed update on the topic. We have two internationally renowned experts in the field of sarcoma as our guest editors for this important issue. Dr Chandrajit P. Raut is Professor of Surgery at Harvard Medical School and Chief of the Division of Surgical Oncology at Brigham and Women's Hospital. Dr Raut also serves as the Surgical Director of the Dana-Farber/Brigham Cancer Center Sarcoma and Bone Oncology Programs. Dr Raut has published extensively on the topic of sarcoma with a research focus on the multidisciplinary management of sarcomas. Specifically, Dr Raut is a leader in the integration of novel targeted therapies into the treatment schema of specific tumors in an effort to improve survival. Serving as coeditor, Dr Alessandro Gronchi is similarly an international leader in the management of sarcoma. Dr Gronchi is the Chair of the Sarcoma Service in the Department of Surgery at Fondazione IRCCS Istituto Nazionale dei Tumori in Milan, Italy. Dr Gronchi serves as chairman of the soft tissue sarcoma committee of the Italian Sarcoma Group, chair of the EORTC Soft Tissue and Bone Sarcoma Group, past-president of the Connective Tissue Oncology Society, as well as a member of the Board of Directors of the Italian Society of Surgical Oncology. Dr Gronchi has authored more than 230 scientific publications and serves as Associate Editor of The Sarcoma Journal. Of note, both Dr Raut and Dr Gronchi help lead a transatlantic collaborative effort on retroperitoneal sarcoma (Transatlantic Retroperitoneal Sarcoma Working Group), which involves over 35 institutions worldwide.

The issue covers a number of important topics, including the treatment and surgical management of patients with a wide range of different sarcoma tumors. In addition, other important topics, such as relevant trial updates, immunotherapy in sarcoma, as well as new drug approvals in the last 5 years for sarcoma, are covered. Furthermore, The Cancer Genome Atlas and its impact and implications on the future directions in the care of sarcoma are also discussed in detail.

I owe Dr Raut and Dr Gronchi a great debt of gratitude for their work in putting together such a fantastic team of sarcoma leaders to contribute to this issue of Surgical Oncology Clinics of North America. These authors have done a masterful job highlighting the important and state-of-the art elements of caring for patients with sarcoma. I know that this issue of Surgical Oncology Clinics of North America will serve trainees and faculty well in familiarizing them with the evolving management of sarcoma. Once again, thank you to Dr Raut, Dr Gronchi, and all the contributing authors.