This phase II trial studies the effect of hypofractionated radiotherapy followed by surgery in treating patients with soft tissue sarcoma. Hypofractionated radiation therapy delivers higher doses of radiation therapy over a shorter period of time and may kill more tumor cells and have fewer side effects. Giving hypofractionated radiotherapy followed by surgery may allow patients with sarcomas to be treated in a much more rapid and convenient fashion.

This clinical trial studies the effect of the ERAS pain management method in managing pain after surgery in patients with extremity soft tissue sarcoma. Enhanced Recovery After Surgery, or ERAS, is a pain management method that places emphasis on managing risk factors (things like smoking, nutrition and fitness), using multiple types of pain control, and early movement, with the goal of improving patient outcomes. ERAS has been shown to reduce the length of time some patients stay in the hospital, reduce complications from surgery, and even lower costs of some surgeries. ERAS is designed may help cut down on the use of these narcotics in managing the pain of surgery patients. The purpose of this trial is to demonstrate that ERAS is safe and effective for patients having surgery to treat their sarcoma. Specifically, this study will look at using a non-narcotic pain management program that includes other methods of managing the pain of sarcoma surgery patients.

This phase III trial compares the effect of open thoracic surgery (thoracotomy) to thoracoscopic surgery (video-assisted thoracoscopic surgery or VATS) in treating patients with osteosarcoma that has spread to the lung (pulmonary metastases). Open thoracic surgery is a type of surgery done through a single larger incision (like a large cut) that goes between the ribs, opens up the chest, and removes the cancer. Thoracoscopy is a type of chest surgery where the doctor makes several small incisions and uses a small camera to help with removing the cancer. This trial is being done evaluate the two different surgery methods for patients with osteosarcoma that has spread to the lung to find out which is better.