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PubMed This is a summary of 17 peer-reviewed journal articles Updated
Oncology

Building Your Care Team: Why Specialized Centers Matter

At a Glance

Because soft tissue sarcoma (STS) is rare, being treated at a specialized high-volume sarcoma center by a multidisciplinary tumor board is crucial. Getting a proper needle biopsy before any surgery prevents dangerous unplanned excisions and improves your overall chances of survival.

Because soft tissue sarcoma (STS) is so rare, the quality of your care depends heavily on the experience of your medical team. Unlike common cancers, where treatment pathways are well-established in community hospitals, sarcoma is a “specialist’s disease” [1]. International guidelines strongly recommend that patients be treated at specialized sarcoma referral centers [2][3].

The Danger of Unplanned Surgery

One of the greatest risks for a new patient is an unplanned excision. This happens when a well-meaning general surgeon removes a lump, assuming it is a harmless cyst or fatty lipoma, without performing a proper needle biopsy first [4][5].

Because sarcomas often look and feel like benign bumps, the surgeon may not take the necessary “wide margins” (extra healthy tissue). If it turns out to be sarcoma, the cancer cells are left behind, significantly increasing the risk of the cancer returning [4][6]. If a sarcoma is not removed correctly the first time, a second, much more extensive “re-excision” surgery is almost always required [4][7].

Red Flag: If a doctor offers to remove a growing, deep, or large lump (over 5 cm) right away in their office or without a prior biopsy, stop and seek a second opinion.

The Power of the Multidisciplinary Tumor Board (MDT)

The cornerstone of specialized care is the Multidisciplinary Tumor Board (MDT). This is a formal committee of experts who meet to review your imaging, pathology, and history to create a unified treatment plan [8][9].

A specialized MDT must include [2][10]:

  • Specialized Pathologist: An expert who sees hundreds of sarcomas a year and can distinguish between 100+ different subtypes [11].
  • Surgical Oncologist: A surgeon specifically trained to remove tumors with “wide margins” while preserving physical function [12].
  • Radiation Oncologist: A specialist who knows how to target radiation to kill microscopic sarcoma cells while protecting healthy tissue [13].
  • Medical Oncologist: A doctor who specializes in the specific chemotherapy and targeted drugs that work for rare sarcoma subtypes [13].

Why Volume Matters

Research consistently shows that patients treated at high-volume centers (hospitals that treat a large number of sarcomas each year) have better outcomes [1][14]. Patients managed by a specialized MDT have significantly higher survival rates than those treated in general community settings [15][16].

How to Find a Specialized Center

When choosing where to receive care, you are not just choosing a doctor; you are choosing an entire system. Look for a center that treats a high volume of cases, conducts weekly MDT meetings, and offers clinical trials [2][17].

You can locate a specialized team by searching for:

  • NCI-Designated Cancer Centers: These are major research hospitals recognized for their high standards of cancer care.
  • The Sarcoma Alliance or the SARC (Sarcoma Alliance for Research through Collaboration) network: These patient advocacy groups maintain lists of vetted sarcoma centers across the country.

Common questions in this guide

What is an unplanned excision?
An unplanned excision happens when a surgeon removes a lump assuming it is a harmless cyst, without doing a needle biopsy first. This can leave cancer cells behind, significantly increasing the risk of the cancer returning and requiring much more extensive surgery later.
Why is it important to go to a specialized sarcoma center?
Because sarcomas are rare, treatment pathways are not as well-established in general community hospitals. Research consistently shows that patients treated at high-volume, specialized sarcoma centers have significantly better outcomes and survival rates.
Who should be on my sarcoma care team?
Your care should be managed by a Multidisciplinary Tumor Board (MDT). This team must include a specialized pathologist, a surgical oncologist, a radiation oncologist, and a medical oncologist who all work together to create a unified treatment plan.
How do I find a specialized sarcoma center near me?
You can locate a specialized team by looking for NCI-Designated Cancer Centers, which are major research hospitals. You can also consult patient advocacy groups like the Sarcoma Alliance or the SARC network for vetted lists of sarcoma centers.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.How many cases of soft tissue sarcoma does this hospital treat every year?
  2. 2.Is my case being formally presented and discussed at a Multidisciplinary Tumor Board (MDT)?
  3. 3.Is my pathologist fellowship-trained specifically in bone and soft tissue sarcomas?
  4. 4.Does this center participate in national clinical trials for sarcomas?
  5. 5.How frequently do the surgeon, radiation oncologist, and medical oncologist at this center work together on the same patient?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (17)
  1. 1

    Traveling to Receive Treatment for Extremity Soft Tissue Sarcomas: Is it worth the drive?

    Vidri RJ, Raut CP, Fitzgerald TL

    World journal of surgery 2021; (45(8)):2415-2425 doi:10.1007/s00268-021-06109-0.

    PMID: 33891137
  2. 2

    [Therapeutic strategy for soft tissue tumors and peripheral sarcomas in adults].

    Bonvalot S, Binder JP, Darrigues L, et al.

    Annales de chirurgie plastique et esthetique 2025; (70(6)):590-597 doi:10.1016/j.anplas.2025.05.008.

    PMID: 41232987
  3. 3

    Seeking international consensus on approaches to primary tumour treatment in Ewing sarcoma.

    Gerrand C, Bate J, Seddon B, et al.

    Clinical sarcoma research 2020; (10(1)):21 doi:10.1186/s13569-020-00144-6.

    PMID: 33292535
  4. 4

    Is Unplanned Excision of Soft Tissue Sarcomas Associated with Worse Oncological Outcomes?-A Systematic Review and Meta-Analysis.

    Larios F, Gonzalez MR, Ruiz-Arellanos K, et al.

    Cancers 2024; (16(2)) doi:10.3390/cancers16020443.

    PMID: 38275885
  5. 5

    Impact of unplanned resection and re-excision of a soft tissue sarcoma on prognosis.

    Muñoz Muñoz P, Bajawi Carretero M, González Barranquero A, et al.

    Cirugia espanola 2020; (98(5)):281-287 doi:10.1016/j.ciresp.2019.10.007.

    PMID: 31806234
  6. 6

    Local recurrence is correlated with decreased overall survival in patients with intermediate high-grade localized primary soft tissue sarcoma of extremity and abdominothoracic wall.

    Zhao R, Yu X, Feng Y, et al.

    Asia-Pacific journal of clinical oncology 2018; (14(2)):e109-e115 doi:10.1111/ajco.12807.

    PMID: 29071781
  7. 7

    Is no additional excision after unplanned excision with positive margins justified in patients with small (≤5 cm) high-grade soft-tissue sarcoma?: Analysis from the Bone and Soft Tissue Tumor registry in Japan.

    Nakamura T, Kawai A, Asanuma K, et al.

    Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 2022; (27(2)):463-467 doi:10.1016/j.jos.2020.12.022.

    PMID: 33549400
  8. 8

    Clinical and surgical effectiveness of the multi-disciplinary standardized management model in the treatment of retroperitoneal liposarcoma: Evidence-based clinical practice experience from Fudan Zhongshan.

    Fan P, Tao P, Wang J, et al.

    Surgery 2024; (175(5)):1368-1376 doi:10.1016/j.surg.2024.01.012.

    PMID: 38395638
  9. 9

    SEOM Clinical Guideline of management of soft-tissue sarcoma (2020).

    de Juan Ferré A, Álvarez Álvarez R, Casado Herráez A, et al.

    Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 2021; (23(5)):922-930 doi:10.1007/s12094-020-02534-0.

    PMID: 33405052
  10. 10

    Outcome of Surgery as Part of Palliative Care of Patients with Symptomatic Advanced or Metastatic Extra-Abdominal High-Grade Soft Tissue Sarcoma.

    Farzaliyev F, Steinau HU, Ring A, et al.

    Palliative medicine reports 2023; (3(1)):64-70 doi:10.1089/pmr.2022.0063.

    PMID: 36941924
  11. 11

    Dedicated review of sarcoma pathology is necessary for corroborative diagnosis in nearly one half of referred patients.

    Eckardt MA, Siena NM, Copeland AR, et al.

    Surgery 2025; (188()):109610 doi:10.1016/j.surg.2025.109610.

    PMID: 41072121
  12. 12

    Adjuvant chemotherapy-Radiotherapy-Chemotherapy sandwich protocol in resectable soft tissue sarcoma: An updated single-center analysis of 104 cases.

    Schliemann C, Kerkhoff A, Hesse P, et al.

    PloS one 2018; (13(5)):e0197315 doi:10.1371/journal.pone.0197315.

    PMID: 29787570
  13. 13

    Soft Tissue Tumors of the Extremity.

    Roland CL

    The Surgical clinics of North America 2020; (100(3)):669-680 doi:10.1016/j.suc.2020.02.015.

    PMID: 32402308
  14. 14

    Soft Tissue Sarcoma of the Extremities: What Is the Value of Treating at High-volume Centers?

    Lazarides AL, Kerr DL, Nussbaum DP, et al.

    Clinical orthopaedics and related research 2019; (477(4)):718-727 doi:10.1097/01.blo.0000533623.60399.1b.

    PMID: 30485258
  15. 15

    Characteristics and Outcomes of Colorectal Cancer Patients Cared for by the Multidisciplinary Team in the Reggio Emilia Province, Italy.

    Mangone L, Marinelli F, Bisceglia I, et al.

    Cancers 2024; (16(13)) doi:10.3390/cancers16132390.

    PMID: 39001450
  16. 16

    The imitation game: large language models versus multidisciplinary tumor boards: benchmarking AI against 21 sarcoma centers from the ring trial.

    Li CP, Kalisa AT, Roohani S, et al.

    Journal of cancer research and clinical oncology 2025; (151(9)):248 doi:10.1007/s00432-025-06304-9.

    PMID: 40926110
  17. 17

    Systemic Therapy in Advanced Pleomorphic Liposarcoma: a Comprehensive Review.

    Assi T, Ngo C, Faron M, et al.

    Current treatment options in oncology 2023; (24(11)):1598-1613 doi:10.1007/s11864-023-01139-3.

    PMID: 37843627

This page is for informational purposes only and does not replace professional medical advice. Always consult a specialized sarcoma care team or oncologist to discuss the best treatment plan for your specific diagnosis.

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