Abstract 5804
Background
Anthracycline/ifosfamide-based neoadjuvant chemotherapy (NAC) is considered to improve survival in adult patients (pts) with high-risk soft tissue sarcoma (HR-STS) [Gronchi A et al., Lanacet Oncology 2017; 18(6):812-22]. Regional hyperthermia (RHT) combined with NAC has significantly improved radiological tumor response and survival in pts with HR-STS [Issels RD, Lindner LH et al., JAMA Oncology 2018 2018 Feb 15. doi: 10.1001/jamaoncol.2017.4996]. The purpose of this retrospective analysis was to assess whether the pathological tumor response after NAC with doxorubicin/ifosfamide (AI) combined with RHT can predict survival outcomes in adult pts with HR-STS.
Methods
In our database, we identified 138 pts who underwent NAC with AI in combination with RHT (01/09 – 10/16) followed by resection of the residual tumor. Pathological response after NAC + RHT was assessed in seventy-five pts and correlated with survival outcome. Pathological grade of regression of the resected tumor was evaluated according to Salzer-Kuntschik et al. and survival parameters using Kaplan Meier. In the patient group, we identified 28 pts with L-sarcoma (LS, lipo- and leiomyosarcoma) and 47 pts with non-LS.
Results
All 75 pts (22 – 78y, median age 60y) received perioperative (1 – 8 cycles, median 6 cycles) combined with RHT (2 – 16 RHT, median 8 RHT), 23 pts underwent neoadjuvant radiotherapy (NAR). Overall survival (OS) and disease progression free survival (DFS) was not significantly improved for a higher grade of regression, whereas pts with pathological regression grade ≥ 3 (n = 26) had a significant better local relapse free survival (LRFS) than pts with regression grade < 3 (n = 49) (p = 0.017).
Conclusions
Histopathological grade of regression after NAC + RHT seems to be predictive for LRFS in adult patients with HR-STS. Further investigations on molecular markers that can predict histopathological response are needed.
Clinical trial identification
Legal entity responsible for the study
Lars Lindner.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.