The extent of local resection and role of adjuvant radiation treatment are well defined. Preoperative radiation treatment in locally advanced STS has several advantages, but increased risk for wound complications has hampered further implementation. The optimal sequence of radiation and surgery remains complex. The reintroduction of ILP with TNF-alpha and melphalan was a breakthrough in limb salvage for primarily unresectable STS. The ILP technique is complex, and is only available in a few cancer centers in Europe. In the combined modality treatment, surgery is still the cornerstone of. The extent of local resection and role of adjuvant radiation treatment are well defined.