The guidelines for the management of soft tissue sarcomas (STS) in the UK, updated from previous versions published in 2010 and 2016, emphasize the importance of expert multidisciplinary team (MDT) care to ensure consistent and optimal treatment. STS are rare tumors arising in mesenchymal tissues and can occur anywhere in the body. The guidelines cover general multidisciplinary management and specific anatomical sites such as gynecological, retroperitoneal, breast, and skin sarcomas. Key recommendations include: 1. **Referral and Assessment**: Patients with unexplained lumps that are increasing in size should undergo a direct access ultrasound scan within 2 weeks. Retroperitoneal or intra-abdominal masses suggestive of STS should be referred to a specialist MDT before biopsy or surgical treatment. 2. **Imaging and Staging**: Ultrasound is an effective initial triage tool, and MRI is recommended for cross-sectional imaging of the primary tumor. CT scans are used for imaging the thorax to detect lung metastases. 3. **Surgery**: Surgery is the standard treatment for adult-type, localized STS. The goal is to completely excise the tumor with a margin of normal tissue. Function-preserving surgery and combined pre- or postoperative radiotherapy are standard treatments for most limb and trunk tumors. 4. **Radiotherapy**: Pre- and post-operative radiotherapy are recommended for most intermediate or high-grade STS. The dose for post-operative radiotherapy is 60-66 Gy, and for pre-operative radiotherapy, it is 50-50.4 Gy. 5. **Chemotherapy**: Neoadjuvant and adjuvant chemotherapy are not routinely recommended but should be considered in high-risk patients, particularly those with more chemo-sensitive subtypes. 6. **Prognosis and Follow-Up**: Prognosis can be estimated using nomograms based on subtype, grade, depth, size, and patient age. Standard follow-up includes clinical history, examination, imaging, and monitoring for late effects of treatment. The guidelines aim to improve the quality of care for patients with STS by providing evidence-based recommendations and fostering collaboration among MDTs.The guidelines for the management of soft tissue sarcomas (STS) in the UK, updated from previous versions published in 2010 and 2016, emphasize the importance of expert multidisciplinary team (MDT) care to ensure consistent and optimal treatment. STS are rare tumors arising in mesenchymal tissues and can occur anywhere in the body. The guidelines cover general multidisciplinary management and specific anatomical sites such as gynecological, retroperitoneal, breast, and skin sarcomas. Key recommendations include: 1. **Referral and Assessment**: Patients with unexplained lumps that are increasing in size should undergo a direct access ultrasound scan within 2 weeks. Retroperitoneal or intra-abdominal masses suggestive of STS should be referred to a specialist MDT before biopsy or surgical treatment. 2. **Imaging and Staging**: Ultrasound is an effective initial triage tool, and MRI is recommended for cross-sectional imaging of the primary tumor. CT scans are used for imaging the thorax to detect lung metastases. 3. **Surgery**: Surgery is the standard treatment for adult-type, localized STS. The goal is to completely excise the tumor with a margin of normal tissue. Function-preserving surgery and combined pre- or postoperative radiotherapy are standard treatments for most limb and trunk tumors. 4. **Radiotherapy**: Pre- and post-operative radiotherapy are recommended for most intermediate or high-grade STS. The dose for post-operative radiotherapy is 60-66 Gy, and for pre-operative radiotherapy, it is 50-50.4 Gy. 5. **Chemotherapy**: Neoadjuvant and adjuvant chemotherapy are not routinely recommended but should be considered in high-risk patients, particularly those with more chemo-sensitive subtypes. 6. **Prognosis and Follow-Up**: Prognosis can be estimated using nomograms based on subtype, grade, depth, size, and patient age. Standard follow-up includes clinical history, examination, imaging, and monitoring for late effects of treatment. The guidelines aim to improve the quality of care for patients with STS by providing evidence-based recommendations and fostering collaboration among MDTs.