Adjuvant chemotherapy for soft tissue sarcoma

Purpose of review: To review current state-of-the-art knowledge about adjuvant medical therapy in adult soft tissue sarcomas. Recent findings: Most recent contributions have added nonrandomized evidence to previously available controlled clinical trials, which were undertaken from the 1970s. Again, results are conflicting, with a limited benefit suggested by some retrospective analyses and denied by others. While a delay in relapse is likely to occur in a fraction of patients treated with adjuvant chemotherapy, a permanent benefit has been more difficult to prove. This result is consistent with findings from previous clinical trials, which pointed to a slight benefit from Doxorubicin-based adjuvant chemotherapy and a possibly higher, although less evidence-based, benefit from anthracycline plus Ifosfamide regimens. Summary: Overall, adjuvant chemotherapy may give some benefit in soft tissue sarcoma. If any, it is likely to be of limited degree, confined to the highest-risk patients, and requiring a fully active chemotherapy regimen. This was mainly shown for extremity soft tissue sarcoma but may also apply to other primary sites. The value of molecular-targeted therapy as an adjuvant for high-risk gastrointestinal stromal tumor patients is a different subject awaiting long-term results of ongoing trials.