BMC Cancer (Sep 2019)

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

  • Kazuhiro Tanaka,
  • Junki Mizusawa,
  • Norifumi Naka,
  • Akira Kawai,
  • Hirohisa Katagiri,
  • Toru Hiruma,
  • Yoshihiro Matsumoto,
  • Hiroyuki Tsuchiya,
  • Robert Nakayama,
  • Hiroshi Hatano,
  • Makoto Emori,
  • Munenori Watanuki,
  • Yukihiro Yoshida,
  • Takeshi Okamoto,
  • Satoshi Abe,
  • Kunihiro Asanuma,
  • Ryohei Yokoyama,
  • Hiroaki Hiraga,
  • Tsukasa Yonemoto,
  • Takeshi Morii,
  • Keisuke Ae,
  • Akihito Nagano,
  • Hideki Yoshikawa,
  • Haruhiko Fukuda,
  • Toshifumi Ozaki,
  • Yukihide Iwamoto

DOI
https://doi.org/10.1186/s12885-019-6114-2
Journal volume & issue
Vol. 19, no. 1
pp. 1 – 7

Abstract

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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/m2 of DXR plus 10 g/m2 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.

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