This Article Full Text Full Text (PDF) All Versions of this Article: theoncologist.2009-0126v1 14/10/1013    most recent eLetters: Submit a response to this article Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Google Scholar Articles by Blay, J.-Y. Articles by Le Cesne, A. PubMed PubMed Citation Articles by Blay, J.-Y. Articles by Le Cesne, A.

Sarcomas

Adjuvant Chemotherapy in Localized Soft Tissue Sarcomas: Still Not Proven

^aCentre Léon Bérard, Medical Oncology Department, Lyon, France; ^bINSERM Unit 590, Group Cytokine and Cancer, Lyon, France; ^cUniversity Claude Bernard Lyon I, Hôpital Edouard Herriot UJOMM, Medical Oncology Unit, Lyon, France; ^dInstitut Gustave Roussy, Villejuif, France

Correspondence: Jean-Yves Blay, M.D., Ph.D., Centre Léon Bérard, 28 Rue Laennec, 69008 Lyon, France. Telephone: +33478782757; Fax: +33478782716; E-mail: BLAY{at}lyon.fnclcc.fr

Received June 22, 2009; accepted for publication September 4, 2009; first published online in THE ONCOLOGIST Express on October 6, 2009.

Disclosures: Jean-Yves Blay: None; Axel Le Cesne: Consultant/advisory role: Novartis, Pfizer, PharmaMar.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.

Soft tissue sarcoma is a rare and heterogeneous group of tumors in terms of histological subtypes, molecular alterations, clinical presentation, and prognosis. Yet, these tumors are most often treated similarly in the localized phase. The standard treatment of these patients requires multidisciplinary management, in particular, careful diagnostic procedures and surgery by an expert physician, preceded or followed by external radiotherapy. The utility of adjuvant chemotherapy has been explored in 14 trials comparing adjuvant chemotherapy with no treatment. Several trials reported a lower risk for local relapse and lower risk for metastatic relapse, but only a few small trials reported longer overall survival. A meta-analysis of all trials failed to demonstrate a significant difference in the relapse-free survival (RFS) or overall survival rates. Two additional trials, reported afterward, presented conflicting results, with a significant benefit in terms of the RFS rate for the trial of the Italian Sarcoma Group, but no difference in the RFS or overall survival rate in the most recent European Organization for Research and Treatment of Cancer trial. We conclude that adjuvant chemotherapy has not been proven to improve the outcome of an unselected population of patients. Several hypotheses are proposed to account for this observation.

This article has been cited by other articles:

				S. M. Schuetze and S. Patel Should Patients with High-Risk Soft Tissue Sarcoma Receive Adjuvant Chemotherapy? Oncologist, October 1, 2009; 14(10): 1003 - 1012. [Abstract] [Full Text] [PDF]