Abstract
BackgroundSoft tissue sarcomas (STS) are rare malignant tumors. The efficacy of preoperative chemotherapy for STS is evaluated using various tumor size-based radiological response criteria. However, it is still unclear which set of criteria would show the best association with pathological response and survival of the patients with STS.MethodsWe compared radiological responses to preoperative chemotherapy for operable STS by the Response Evaluation Criteria in Solid Tumors (RECIST), modified RECIST, World Health Organization criteria, Japanese Orthopaedic Association criteria, and modified Choi criteria and analyzed the association with pathological response and survival using the data from the Japan Clinical Oncology Group (JCOG) study JCOG0304, a phase II clinical trial evaluating the efficacy of perioperative chemotherapy for STS in the extremities.ResultsSeventy eligible patients in JCOG0304 were analyzed. The results demonstrated that none of the size-based radiological response criteria showed significant association with pathological response to preoperative chemotherapy for STS. The difference between overall survival of the patients assessed as partial response and stable disease/progressive disease by RECIST was not significant (hazard ratio 1.37, p = 0.63), and calculated C-index was 0.50. All other response criteria also could not exhibit significant association between radiological responses and survival.ConclusionIn the present study, none of the radiological response criteria analyzed demonstrated association of response to preoperative chemotherapy with pathological response or survival of the patients with operable STS. Further prospective investigation is required to develop criteria to evaluate not only tumor shrinkage but biological effects of preoperative chemotherapy for the patients with localized STS.Trial registrationUMIN Clinical Trials Registry C000000096. Registered 30 August, 2005 (retrospectively registered).
Highlights
Soft tissue sarcomas (STS) are rare malignant tumors
Response to preoperative chemotherapy A total of 72 patients who suffered from operable highgrade STS in the extremities were enrolled in the JCOG0304 trial (Fig. 1)
By World Health Organization (WHO) criteria, 15 partial response (PR), 49 stable disease (SD), and 6 progressive disease (PD) were found, and response rate was 21.4%
Summary
Soft tissue sarcomas (STS) are rare malignant tumors. The efficacy of preoperative chemotherapy for STS is evaluated using various tumor size-based radiological response criteria. It is still unclear which set of criteria would show the best association with pathological response and survival of the patients with STS. The responses to preoperative chemotherapy for operable STS have been evaluated using tumor size-based radiological response criteria such as the World Health Organization (WHO) [9], Response Evaluation Criteria in Solid Tumors (RECIST) [10], JOA [11], and Choi [12]. The surrogacy of the radiological responses to chemotherapy for survival of the patients with operable STS is still controversial
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