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Effect of adjuvant chemotherapy on survival in FNCLCC grade 3 soft tissue sarcomas: a multivariate analysis of the French Sarcoma Group Database

2010; Elsevier BV; Volume: 21; Issue: 12 Linguagem: Inglês

10.1093/annonc/mdq238

1569-8041

Antoîne Italiano, Fleur Delva, Simone Mathoulin‐Pélissier, Axel Le Cesne, Sylvie Bonvalot, Philippe Terrier, Martine Trassard, Jean Jacques Michels, Jean‐Yves Blay, Jean‐Michel Coindre, B. Bui,

Cardiac tumors and thrombi

BackgroundThe predictive value of grade for benefit from adjuvant chemotherapy (AC) in soft tissue sarcoma (STS) patients has never been explored.Patients and methodsFrom 1980 to 1999, 1513 adult patients with non-metastatic STS were included prospectively in the French Sarcoma Group database. Grade was assessed according to the Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) system after central review.ResultsAC was delivered to 13 grade 1 patients (3%), 145 grade 2 patients (35%) and 262 grade 3 patients (62%). Young age, non-well-differentiated liposarcoma histology, deep location, bone and/or neurovascular invasion and grade 2 or 3 were significantly associated with a higher likelihood to receive AC. Median follow-up was 9 years. On multivariate analysis, AC was significantly associated with improved metastasis-free survival (MFS) [5-year MFS: 58% versus 49%, hazard ratio (HR) 0.7 (95% confidence interval (CI) 0.6–0.9), P = 0.01] and overall survival (OS) [5-year OS: 58% versus 45%, HR 0.6 (95% CI 0.5–0.8), P = 0.0002] in grade 3 patients. This was not observed in grade 2 patients [5-year MFS: 76% versus 73%, HR 0.8 (95% CI 0.5–1.2), P = 0.27; 5-year OS: 75% versus 65%, HR 0.8 (95% CI 0.6–1.1), P = 0.15].ConclusionsThis large cohort-based analysis with long-term follow-up indicates that patients with FNCLCC grade 3 disease may benefit from AC.