手术仍是肢体软组织肉瘤最重要的治疗方法。随着现代外科技术及治疗理念的变化，肢体肉瘤的手术已由截肢为主演变为保肢手术和功能重建相结合的模式，广泛切除是最常用的术式，切除范围至少应包括肿瘤周围1 cm正常组织或相当厚度的筋膜组织。边缘切除结合辅助治疗可用于少数肿瘤邻近重要神经血管或骨骼的病人，但应保证肿瘤切除的彻底性。累及血管神经或骨骼的肉瘤往往需要进行重建。少数病人血管神经广泛受累，残肢功能不优于假肢时仍需要考虑截肢治疗。

Decision making of surgery type and resection extent in extremity soft tissue sarcomas        CHEN Yong. Department of Gastric and Soft Tissue Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Abstract    Surgical resection remains the mainstay of treatment for extremity soft tissue sarcomas (STS). With the development of modern surgical technologies and theories, the surgical treatment of STS has been developed into a multidisciplinary model which mainly includes limb-sparing resection and functional reconstruction. Wide local excision with at least 1 cm of normal tissue around the tumor is the current surgical goal. Marginal resection combined with adjuvant therapy could be used in case of proximity to vital structures. Removal of neurovascular bundles or bony structures necessitates reconstruction in limb-sparing surgeries. Amputation should be taken into consideration when a non-functional residual limb will be left after massive resection of neurovascular bundles and surrounding soft tissue.