Ten-year follow-up results of perioperative chemotherapy with doxorubicin and ifosfamide for high-grade soft-tissue sarcoma of the extremities: Japan Clinical Oncology Group study JCOG0304

Abstract

Background Soft-tissue sarcomas (STS) are rare malignant tumors those are resistant to chemotherapy. We have previously reported the 3-year follow-up result on the efficacy of perioperative chemotherapy with doxorubicin (DXR) and ifosfamide (IFM) for high-risk STS of the extremities (JCOG0304). In the present study, we analyzed the 10-year follow-up results of JCOG0304. Methods Patients with operable, high-risk STS (T2bN0M0, AJCC 6th edition) of the extremities were treated with 3 courses of preoperative and 2 courses of postoperative chemotherapy, which consisted of 60 mg/m 2 of DXR plus 10 g/m 2 of IFM over a 3-week interval. The primary study endpoint was progression-free survival (PFS) estimated by Kaplan-Meier methods. Prognostic factors were evaluated by univariable and multivariable Cox proportional hazards model. Results A total of 72 patients were enrolled between March 2004 and September 2008, with 70 of these patients being eligible. The median follow-up period was 10.0 years for all eligible patients. Local recurrence and distant metastasis were observed in 5 and 19 patients, respectively. The 10-year PFS was 65.7% (95% CI: 53.4–75.5%) with no PFS events being detected during the last 5 years of follow-up. The 10-year overall survival was 78.1% (95% CI: 66.3–86.2%). Secondary malignancy was detected in 6 patients. The subgroup analysis demonstrated that there was significant difference in survival with regard to primary tumor size. Conclusions Only a few long-term results of clinical trials for perioperative chemotherapy treatment of STS have been reported. Our results demonstrate that the 10-year outcome of JCOG0304 for patients with operable, high-risk STS of the extremities was stable and remained favorable during the last 5 years of follow-up. Trial registration This trial was registered at the UMIN Clinical Trials Registry as C000000096 on August 30, 2005. Electronic supplementary material The online version of this article (10.1186/s12885-019-6114-2) contains supplementary material, which is available to authorized users.

Surgical Resection of Undifferentiated Pleomorphic Sarcoma (UPS) With Jejunal Perforation, A Suspected Case of Metastasis of Lung Cancer: A Case Report

“…Gronchi et al and the Japan Clinical Oncology Group 0304 trial, in prospective studies, have shown the e cacy of the combination of adriamycin and ifosfamide as preoperative adjuvant chemotherapy. The European Society for Medical Oncology-European Reference network for rare adult solid cancers clinical practice guidelines also recommend the use of preoperative adjuvant chemotherapy for high-grade malignancies, deep-seated tumors, tumor diameters of 5 cm or greater, and soft tissue sarcomas of the limbs or trunk [19,20]. In this case, the patient was treated with pembrolizumab, an immune checkpoint inhibitor, for his lung cancer.…”

Surgical resection of undifferentiated pleomorphic sarcoma (UPS) with jejunal perforation, a suspected case of metastasis of lung cancer

“…Gronchi et al and the Japan Clinical Oncology Group 0304 trial, in prospective studies, have shown the efficacy of the combination of adriamycin and ifosfamide as preoperative adjuvant chemotherapy. The European Society for Medical Oncology-European Reference network for rare adult solid cancers clinical practice guidelines similarly recommend the use of preoperative adjuvant chemotherapy for high-grade malignancies, deep-seated tumours, tumour diameters of 5 cm or greater, and soft tissue sarcomas of the limbs or trunk [22,23]. In this case, the patient was treated with pembrolizumab, an immune checkpoint inhibitor, for his lung cancer.…”

Standardization of evaluation method and prognostic significance of histological response to preoperative chemotherapy in high-grade non-round cell soft tissue sarcomas

“…Preoperative chemotherapy has been reported to be effective for localized high-risk STS [ 3 ]. The current standard preoperative chemotherapy for STS is anthracyclin-containing regimen including a combination of doxorubicin (DOX) and ifosfamide (IFO) is widely accepted [ 4 – 7 ].…”