Adjuvant chemotherapy in localized, resectable extremity and truncal soft tissue sarcoma: systematic review and meta-analysis

There is no consensus of the role of adjuvant chemotherapy in localized, resectable soft tissue sarcomas (STSs). Systematic review and meta-analysis of 19 randomized controlled trials found that adjuvant chemotherapy in patients with localized, resectable STS of extremities or trunk was associated with signficantly improved disease-free survival (HR 0.78; p=0.002) and overall survival (HR 0.80; p=0.002). Adjuvant doxorubicin-based monotherapy significantly improved DFS (HR 0.74; p=0.0003) and OS (HR 0.80; p=0.01), whereas doxorubicin-ifosfamide combined therapy did not significantly improve DFX (Hr 0.94; p=0.770) or OS (HR 0.78; p=0.078). The authors conclude that this analysis partly supports the benefit of adjuvant chemotherapy in the treatment of localized, resectable STSs. Nevertheless, because of the heterogeneity of STSs, the use of adjuvant chemotherapy needs to be evaluated on an individual benefit-risk analysis.