SELNET clinical practice guidelines for soft tissue sarcoma and GIST

Overview

Soft tissue sarcomas and gastrointestinal stromal tumours (GIST) are rare cancers with many subtypes, which makes accurate diagnosis and optimal treatment difficult outside specialised settings. These guidelines were developed by SELNET, the Sarcoma European and Latin American Network. They provide consensus recommendations across the whole care pathway, with particular attention to adapting care to different healthcare resources.

Diagnosis and staging

A central principle is that patients with suspected sarcoma should be referred to a reference centre or a network with multidisciplinary sarcoma expertise before any treatment. Diagnosis should be established by appropriate biopsy before definitive surgery, and interpreted by an experienced pathologist. Molecular testing is used where it helps confirm the subtype. Imaging-based staging guides treatment planning.

Treatment of soft tissue sarcoma

Surgery aimed at complete removal with adequate margins remains the cornerstone of curative treatment for localised disease. Radiotherapy is used in selected cases to improve local control. The role of systemic therapy depends on subtype, stage and patient factors. Treatment decisions should be made by a multidisciplinary tumour board.

GIST

For GIST, mutational analysis is essential because it predicts sensitivity to targeted therapy and informs treatment choices. After surgery, risk stratification determines which patients benefit from adjuvant targeted treatment. Advanced disease is managed with sequential targeted therapies and, in selected cases, surgery.

Clinical implications

The guidelines promote centralised expertise, standardised pathology and structured follow-up. They acknowledge differences in access between regions and aim to support high-quality, feasible sarcoma care in both European and Latin American settings.