Perioperative chemotherapy is not associated with improved survival in high-grade truncal sarcoma

• Published in: The Journal of surgical research 2018-11, Vol.231, p.248-256
• Main Authors: Yu, Peter Y., Beal, Eliza W., Hughes, Tasha M., Suarez-Kelly, Lorena P., Shelby, Rita D., Ethun, Cecilia G., Tran, Thuy B., Poultsides, George, Charlson, John, Gamblin, T. Clark, Tseng, Jennifer, Roggin, Kevin K., Chouliaras, Konstantinos, Votanopoulos, Konstantinos, Krasnick, Bradley A., Fields, Ryan C., Pollock, Raphael E., Grignol, Valerie, Cardona, Kenneth, Howard, J. Harrison
• Format: Article
• Language: English
• Subjects: Chemotherapy; High-grade; Sarcoma; Surgery; Survival; Trunk
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2018.05.030

The treatment benefit of perioperative chemotherapy (CTX) for truncal soft tissue sarcoma (STS) is not well established. This study evaluates the association of CTX with survival for patients with resected primary high-grade truncal STS. Adult patients with high-grade truncal STS who had curative-intent resection from 2000 to 2016 at seven U.S. institutions were evaluated retrospectively. Patients were stratified by receipt of CTX. Kaplan–Meier curves with log-rank tests were used to compare overall survival (OS) and recurrence-free survival. Logistic regression models were used to evaluate characteristics associated with OS. Of patients with primary high-grade truncal STS, 235 underwent curative-intent resections. The most common histology was undifferentiated pleomorphic sarcoma and mean tumor size was 7.8 cm. Thirty percent of the patients received CTX (n = 70). Among patients receiving CTX, 34% (n = 24) had neoadjuvant CTX, 44% (n = 31) adjuvant CTX, and 21% (n = 15) had neoadjuvant and adjuvant CTX. Patients receiving CTX were more likely to receive radiation (51% versus 34%, P = 0.01), have deep tumors (86% versus 73%, P = 0.037) and solid organ invasion (14% versus 3%, P = 0.001). On univariate analysis, patients who received CTX had worse OS (P