AI Article Synopsis
- Patients with primary high-grade retroperitoneal soft tissue sarcomas have a challenging prognosis, with a 5-year disease-specific survival (DSS) rate of under 40%, and the effects of neoadjuvant therapy on survival are not well understood.
- A study of 55 patients who received neoadjuvant therapy showed a median tumor size of 15 cm and a 5-year DSS of 47%, which did not significantly differ from what was predicted by a sarcoma nomogram.
- Among the patients, 25% showed a strong histopathologic response (>95% necrosis), resulting in an impressive 5-year DSS of 83%, significantly better than the 34% for nonresponders, indicating that
Article Abstract
Background: Patients with primary high-grade retroperitoneal soft tissue sarcomas have a 5-year disease-specific survival (DSS) of <40%. The impact of neoadjuvant therapy on histopathologic response and DSS are unknown.
Methods: From 1987 to 2007, 55 patients with primary high-grade retroperitoneal sarcoma received neoadjuvant therapy. All patients underwent surgical resection, and response was assessed histopathologically. Patients with >or=95% pathologic necrosis were classified as responders. Clinicopathologic variables were analyzed for association with DSS. Observed DSS was then compared with the Memorial Sloan-Kettering Cancer Center Sarcoma Nomogram predicted DSS.
Results: The median tumor size was 15 cm, and the median follow-up time for survivors was 68 months. The 5-year DSS for all 55 patients was 47% and did not significantly differ from the 37% predicted by the sarcoma nomogram for such patients (P=.44). Fourteen (25%) of the patients had >or=95% pathologic necrosis and were defined as responders; 41 (75%) were nonresponders. The 5-year DSS for responders was 83%. This was significantly better than the 5-year DSS of 34% for nonresponders (P=.002) and the 39% predicted by the sarcoma nomogram for responders (P=.018). The 34% 5-year DSS for nonresponders did not significantly differ from the 35% predicted by the sarcoma nomogram (P=.51).
Conclusions: Neoadjuvant therapy was not associated with an overall improvement in DSS in patients with primary high-grade retroperitoneal sarcoma compared with the sarcoma nomogram prediction. Histopathologic response to neoadjuvant therapy was associated with a significantly improved DSS compared with nonresponders and with the sarcoma nomogram prediction for such patients.
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| http://dx.doi.org/10.1002/cncr.25271 | DOI Listing |
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