A Randomized Phase III Study of Neoadjuvant Chemotherapy Followed by Surgery Versus Surgery Alone for Patients with High-Risk Retroperitoneal Sarcoma (STRASS2)

• Authors: Jacob Lambdin, National Institutes of Health; Carrie Ryan, National Institutes of Health; Stephanie Gergory, National Institutes of Health; Ken Cardona, Emory University; Jonathan M. Hernandez, National Institutes of Health; Winan J. van Houdt, Netherlands Cancer Institute; Alessandro Gronchi, Fondazione IRCCS Istituto Nazionale dei Tumori
• Journal Title: Annals of Surgical Oncology
• Volume: Volume 30, Number 8
• Publisher: Springer Nature Link | 2023-05-11, Pages 4573-4575
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1245/s10434-023-13500-9
• Subjects: Health Sciences, Oncology; Health Sciences, Medicine and Surgery
• Keywords: Retroperitoneal soft tissue sarcomas (RPS); rare cancers; histologic type and tumor grade; perioperative therapy

Abstract

Retroperitoneal soft tissue sarcomas (RPS) are a heterogeneous group of rare cancers, accounting for approximately 15% all diagnosed adult soft tissue sarcomas.1 Five-year survival is reported to be around 60% but varies by histologic type and tumor grade.1,2 Certain types, such as retroperitoneal grade 3 dedifferentiated liposarcoma (DDLPS) and leiomyosarcoma (LMS) are particularly recalcitrant, with 5-year recurrence rates around 80% following surgical extirpation.2,3 Nonetheless, histology-tailored en-bloc resection is the mainstay of therapy. Contrary to the neoadjuvant and perioperative treatment schemas that are increasingly utilized for truncal and extremity soft tissue sarcomas, the role of perioperative therapy remains controversial for RPS 4 despite recent efforts. For example, the STRASS trial evaluated the role of neoadjuvant radiotherapy in RPS and found that the role of radiation for patients with RPS was limited and linked to histologic type and malignancy grade.5 Specifically, while there was no benefit for high-grade RPS, radiotherapy did appear to have value for patients with grade 1–2 liposarcoma.