The management of sarcomas, particularly soft-tissue sarcomas, presents significant challenges due to their rarity and the limited treatment options available. A phase II trial by Siontis et al. evaluated the combination of trabectedin and olaparib in patients with advanced unresectable or metastatic sarcoma, revealing promising efficacy and safety profiles, particularly in patients who had undergone at least one prior therapy (ref: Siontis doi.org/10.1158/1078-0432.CCR-25-0298/). In a collaborative study by van der Burg et al., the relationship between radiologic and pathologic responses after neoadjuvant chemotherapy for primary retroperitoneal sarcoma was explored. The findings indicated that early radiologic progression was significantly associated with worse overall survival, highlighting the importance of timely response evaluation (ref: van der Burg doi.org/10.1245/s10434-025-17306-9/). Furthermore, Musa et al. conducted a retrospective cohort study that underscored the necessity of histology-driven surgical approaches, finding that complete response (CR) was linked to improved disease-specific survival (DSS) in patients with liposarcoma, while this was not the case for leiomyosarcoma (ref: Musa doi.org/10.1093/bjsopen/). Lastly, Ray et al. reported on the long-term outcomes of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy for peritoneal sarcomatosis from uterine sarcoma, demonstrating high cytoreduction rates and extended survival, thus advocating for this multimodal approach in select patients (ref: Ray doi.org/10.1016/j.ejogrb.2025.114042/).

Histopathological characteristics play a crucial role in determining the prognosis of sarcomas. A study by Devins et al. focused on low-grade endometrial stromal sarcoma (LG-ESS) and identified significant clinicopathologic features associated with recurrence-free survival, such as cervical stromal involvement and myxoid stroma (ref: Devins doi.org/10.1097/PAS.0000000000002428/). Han et al. provided a comprehensive analysis of 97,062 sarcoma patients, revealing substantial variations in clinical behavior and prognosis across different histological subtypes, emphasizing the need for tailored treatment strategies based on histology (ref: Han doi.org/10.3390/cancers17101706/). Additionally, Hojný et al. utilized RNA sequencing to decode the molecular landscape of 262 uterine sarcomas, identifying distinct clusters with prognostic implications, particularly highlighting the differences between high-grade endometrial stromal sarcomas with and without specific fusions (ref: Hojný doi.org/10.1016/j.labinv.2025.104198/). Yuan et al. investigated orosomucoid 1 as a potential prognostic biomarker in uterine sarcoma, finding significant downregulation in various sarcoma subtypes compared to normal tissue, which could aid in prognostic assessments (ref: Yuan doi.org/10.1177/15330338251343487/). Lastly, Gant et al. examined CD140b expression in atypical fibroxanthoma and pleomorphic dermal sarcoma, suggesting its potential as a diagnostic marker, thus contributing to the understanding of these closely related tumors (ref: Gant doi.org/10.1097/PAI.0000000000001267/).

Molecular and genetic insights into sarcomas have revealed significant heterogeneity and potential therapeutic targets. Yin et al. reported a rare case of CD34-positive pleomorphic uterine sarcoma with a NUDT3::RAD51B fusion, emphasizing the aggressive nature of RAD51B-rearranged sarcomas and the need for awareness of these rare entities (ref: Yin doi.org/10.1007/s00428-025-04126-1/). Younes et al. conducted a clinicopathologic analysis of primary penile mesenchymal tumors, uncovering a diverse group of neoplasms that, despite their rarity, require careful diagnostic consideration and management (ref: Younes doi.org/10.1016/j.humpath.2025.105814/). Codispoti et al. presented a case of epithelioid leiomyosarcoma with a CDKN2C/CIC null profile, highlighting the emerging molecularly defined subtypes of uterine leiomyosarcoma and their implications for diagnosis and treatment (ref: Codispoti doi.org/10.1097/PGP.0000000000001114/). These studies collectively underscore the importance of molecular characterization in guiding treatment decisions and improving patient outcomes in sarcoma management.

Rare subtypes of sarcomas present unique challenges in diagnosis and treatment. Alimi et al. reported a case of primary breast leiomyosarcoma, which is exceedingly rare, accounting for only about 1% of breast tumors. The lack of standardized treatment guidelines for such rare malignancies complicates management strategies (ref: Alimi doi.org/10.4274/ejbh.galenos.2025.2024-10-8/). Burkhard-Meier et al. investigated the prognostic factors associated with pulmonary metastasectomy for soft tissue sarcoma, revealing that a maximal lesion diameter greater than 2 cm significantly predicted reduced disease-free survival (DFS) and overall survival (OS), thus providing critical insights for surgical decision-making in rare metastatic presentations (ref: Burkhard-Meier doi.org/10.1245/s10434-025-17450-2/). The findings from these studies highlight the necessity for further research into the management of rare sarcoma subtypes, as well as the importance of individualized treatment approaches based on specific tumor characteristics.

Outcomes and survival analysis in sarcoma are critical for understanding disease progression and treatment efficacy. Burkhard-Meier et al. provided insights into the impact of tumor size on survival outcomes after pulmonary metastasectomy, demonstrating that lesions larger than 2 cm were associated with significantly worse DFS and OS, thus emphasizing the importance of tumor size in prognostic assessments (ref: Burkhard-Meier doi.org/10.1245/s10434-025-17450-2/). Musa et al. further contributed to this theme by showing that complete response (CR) in patients with liposarcoma correlated with improved disease-specific survival, while CR did not yield similar benefits in leiomyosarcoma, indicating the need for histology-specific treatment strategies (ref: Musa doi.org/10.1093/bjsopen/). These findings collectively underscore the importance of tailored approaches in sarcoma management, taking into account both histological subtype and tumor characteristics to optimize patient outcomes.