Background: MT applies to a selected group of pts with a/m STS. The impact of MT on prognosis remains undefined. We report results on palliative medical treatment (Rx) with MT(+) or without MT(-) in a/mSTS pts. Methods: Within the observation period 12/1998–05/2016 a/mSTS pts were identified from medical records, retrospectively. All pts received Rx. MT(+) pts received in addition surgery (Sx) with or without radiotherapy (RTx) throughout the course of treatment. Overall survival (OS) was defined as time from first palliative treatment until death. Descriptive statistics Kaplan-Meier and Log-rank analysis, as well as Cox-regression and Land-mark analyses were applied. Results: 111/181 a/mSTS pts (61.3%) received MT(+). Number of lines of Rx where similar among both groups. MT(+) pts received a median of 1 Sx (range (r):0-7) and 1 RTx (r: 0-8). The median OS of all pts was 18 (95%CI:14.1-21.9) months (mo), while MT(+) patients showed a superior OS of 22 (95%CI: 15.2-28.8) mo vs. MT(-) of 15 (95%CI:8.8-21.2) mo p = .029). Among MT(+) pts, OS improvement was associated with the use of Rx+Sx±RTx (p≤.001), which remained significant at 3- (p = .001) and 6-mo land-marks (p = .004). While Rx+RTx was not identified as independently associated with risk of death, Rx+Sx±RTx showed a independent association with decreased risk of death (HR:0.45 (95%CI: 0.4-0.8); p = .004). Conclusions: MT in a/mSTS within the palliative treatment sequence was performed in a relevant proportion of pts at our center. MT was associated with superior OS, mainly in pts receiving Rx+Sx ±RTx within 6 months upon first palliative treatment, rendering additive surgery the preferred approach within the multimodal strategy.