1. The role of perioperative chemotherapy in primary high-grade extremity soft tissue sarcoma
- Author
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Ibtissam Acem, Winan J. van Houdt, Dirk J. Grünhagen, Winette T.A. van der Graaf, Anja J. Rueten-Budde, Hans Gelderblom, Cornelis Verhoef, Michiel A.J. van de Sande, Will Aston, Han Bonenkamp, Ingrid M.E. Desar, Peter C. Ferguson, Marta Fiocco, Robert J. van Ginkel, Anthony M. Griffin, Rick L. Haas, Jos A. van der Hage, Andrew J. Hayes, Lee M. Jeys, Akira Kawai, Johnny Keller, Minna K. Laitinen, Katja Maretty-Kongstad, Koichi Ogura, Toshifumi Ozaki, Rob Pollock, Veroniek M. van Praag, Stefan Sleijfer, Myles J. Smith, Maria A. Smolle, Emelie Styring, Joanna Szkandera, Kazuhiro Tanaka, Per-Ulf Tunn, Madeleine Willegger, Reinard Windhager, Jay S. Wunder, Olga Zaikova, Surgery, and Medical Oncology
- Subjects
Cancer Research ,Soft tissue sarcoma ,Sarcoma ,Soft Tissue Neoplasms ,Extremities ,Anthracycline ,Oncology ,SDG 3 - Good Health and Well-being ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Chemotherapy ,Ifosfamide ,Prediction ,Retrospective Studies ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
Objective: The aim of the study is to assess the effect of perioperative chemo-therapy (CTX) in patients with grade II-III extremity soft tissue sarcoma (eSTS) on overall survival (OS) and evaluate whether the PERSARC prediction tool could identify patients with eSTS more likely to benefit from CTX.Methods: Patients (18-70 years) with primary high-grade eSTS surgically treated with cura-tive intent were included in the retrospective cohort study. The effect of any perioperative CTX and anthracycline + ifosfamide (AI)-based CTX on OS was investigated in three PERSARC-risk groups (high/intermediate/low). The PERSARC-risk groups were defined by the 33% and 66% quantile of the predicted 5-year OS of the study population equal to a 5-year OS of 65.8% and 79.8%, respectively. The effect of CTX on OS was investigated with weighted Kaplan-Meier curves and multivariable Cox models with an interaction between risk group and CTX.Results: This study included 5683 patients. The weighted Kaplan-Meier curves did not demonstrate a beneficial effect of any CTX and AI-based CTX on OS in the overall population. However, in the high PERSARC-risk group the 5-year OS of AI-based CTX was significantly better than no CTX (69.8% vs 59.0%, respectively, p Z 0.004) (HR 0.66, 95% CI 0.53-0.83).Conclusions: This study demonstrated a beneficial effect of AI-based CTX on OS in a selected group of high-risk patients with an absolute survival benefit of 11% as stratified by the PERSARC prediction tool. However, no beneficial effect of CTX on OS was found in the overall population of patients with primary high-grade eSTS younger than 70 years.(c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
- Published
- 2022