Treatment for Undifferentiated Pleomorphic Sarcoma

Surgical Management

• Wide excision should be performed with the goal of achieving negative histopathological margins for primary tumors, according to the British Journal of Cancer guidelines 1
• Preoperative core/punch biopsy is recommended to secure diagnosis before definitive surgery, especially for tumors in anatomically challenging locations, as suggested by the British Journal of Cancer 2

Adjuvant Therapy

Radiotherapy

• Adjuvant radiotherapy should be considered when surgical margins are positive or close, for tumors in locations where wide excision is not possible, or for high-grade tumors with adverse features, as recommended by the British Journal of Cancer 2, 3
• Reconstructive procedures should be planned to be robust enough to tolerate postoperative radiotherapy, according to the British Journal of Cancer guidelines 2

Chemotherapy

• No relevant cited facts are available for chemotherapy

Management of Advanced/Metastatic Disease

• For oligometastatic disease, local treatments such as surgery, radiofrequency ablation, cryotherapy, or stereotactic radiotherapy should be considered, as suggested by the British Journal of Cancer 1

Follow-up

• Regular follow-up is essential for early detection of recurrence, with follow-up every 3-4 months in the first 2-3 years, then twice a year up to the fifth year, and once a year thereafter, as recommended by the Annals of Oncology 4
• Imaging should include assessment of the primary site and chest imaging to detect potential metastases, according to the Annals of Oncology guidelines 4

Special Considerations

• UPS management should be discussed in a specialized sarcoma multidisciplinary team, as recommended by the British Journal of Cancer 2, 3
• For tumors in challenging anatomical locations, preoperative treatment may be considered to reduce tumor size and facilitate surgical resection, as suggested by the Annals of Oncology 5