Histopathological response after neoadjuvant chemotherapy for high-risk soft-tissue sarcomas: secondary analysis of a randomized trial

Treatment of high-risk soft-tissue sarcoma (STS) of extremities or trunk wall involves neoadjuvant chemotherapy (NACT) followed by surgery. Secondary analysis of a multinational randomized trial investigated whether histopathological response after NACT was associated with outcomes in high-risk STS patients. In this secondary analysis of 388 patients, the proportion of stainable tumor cells was not associated with disease-free survival (DFS), whereas necrosis was associated with worse DFS, and presence of sclerohyalinosis greater than 20% was associated with improved DFS. The authors conclude that these findings suggest that the presence of sclerohyalinosis may serve as a novel histopathological marker of favorable response to NACT in STS.