The role of adjuvant chemotherapy in children and adolescents with surgically resected, high-risk adult-type soft tissue sarcomas

Andrea Ferrari, Ines B. Brecht, Ewa Koscielniak, Michela Casanova, Angela Scagnellato, Gianni Bisogno, Rita Alaggio, Giovanni Cecchetto, Serena Catania, Cristina Meazza, Christoph Int-Veen, Sylvia Kirsch, Tobias Dantonello, Modesto Carli, Joern Treuner

Research output: Contribution to journalArticlepeer-review


Purpose. This analysis evaluates whether adjuvant chemotherapy can be recommended for high-risk, surgically-resected, adult-type non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) within the new European Pediatric Soft Tissue Sarcoma Study Group (EpSSG) protocol. The Italian and German Cooperative Groups reviewed their data-bases, analyzing patients classified as group I-II, with high-grade tumor (G3) larger than 5 cm in size. Methods. The analysis included 36 patients, and compared the clinical features and outcome of the group of 21 patients who received chemotherapy versus the group of 15 patients treated with local therapies only. Results. For the series as a whole, 5-year event-free survival (EFS), metastasis-free survival (MFS), and overall survival (OS) were 26.2%, 34.0%, and 37.5%, respectively. In patients treated with chemotherapy, MFS and OS were 49.5% and 41.5% (median time to relapse: 13 months). In patients who did not receive chemotherapy, MFS and OS were 0% and 23.8% (median time to relapse: 3 months). Conclusion. The role of adjuvant chemotherapy in NRSTS is still uncertain, however, the current retrospective analysis showed that: (1) despite the globally good prognosis of grossly-resected cases, patients with G3 and large-size have a high-risk of metastatic spread, and (2) MFS appears to be better in patients who had chemotherapy. Based in part on these results, and in accordance with recent suggestions coming from the literature on adult sarcomas, the EpSSG NRSTS protocol will recommend adjuvant chemotherapy in high-risk surgically-resected patients.

Original languageEnglish
Pages (from-to)128-134
Number of pages7
JournalPediatric Blood and Cancer
Issue number2
Publication statusPublished - Aug 2005


  • Adjuvant chemotherapy
  • Adult-type soft tissue sarcomas
  • Non-rhabdomyosarcoma soft tissue sarcomas
  • Pediatric soft tissue sarcomas

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Pediatrics, Perinatology, and Child Health


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