How would you approach adjuvant treatment in a patient with completely resected undifferentiated pleomorphic sarcoma of the chest wall that recurred after 2 years, initially treated with neoadjuvant radiation and resection?  

There is no evidence to support adjuvant treatment after re-resection. In the case of recurrence, we prefer to biopsy the mass to prove recurrence and obtain tissue (for NGS). In the case of recurrence, if we were to give systemic therapy, then we would favor neoadjuvant chemotherapy- provided this ...

Presume that the recurrence has been re-resected? In which case, I don't think there is evidence for adjuvant therapy. If there is the opportunity for a radiation boost to the area, that would be reasonable to have that consult with rad onc.

There is a lot of information missing here. Grade and size at initial presentation and at recurrence? Margin status on each surgery? Why was neoadjuvant therapy not considered? Review in detail the prior RT plan as well as the initial op note and path report - there is usually an explanation for the...