THE OUTCOME OF ADVANCED SOFT-TISSUE SARCOMA PATIENTS WITH COMPLETE TUMOR-REGRESSION AFTER EITHER CHEMOTHERAPY ALONE OR CHEMOTHERAPY PLUS SURGERY - THE SCANDINAVIAN SARCOMA GROUP EXPERIENCE

The intensified induction regimens used and the potential use of high- dose consolidation chemotherapy (CT) in advanced soft tissue sarcomas (STS) has focused interest on the outcome of those patients who can ac hieve complete remission (CR) by current therapy. The files from four institutions with a special interest in STS were studied. 38 adult pat ients with advanced STS who were converted disease-free by either CT a lone (n = 14) or CT followed by surgery (n = 24) were found. The media n follow-up time was 29 months. The median disease-free survival (DFS) was 18 months and the estimated 2-year DFS 34%. The median disease-sp ecific survival (DSS) was 40 months and the estimated 2-year DSS 78%. For patients who achieved CR by CT alone, and for patients who were co nverted to CR by surgery, the corresponding DFS figures were 23 months (estimated 2 year DFS 48%) and 10 months (26%) (P = 0.07), respective ly. The histological response to CT significantly predicted outcome in patients subjected to surgery (DFS P value 0.004, DSS P value 0.02). Patients who achieved CR by surgery shortly after having achieved a cl inical partial response (PR with early surgery) did better than those who where converted to CR by surgery after protracted CT following a c linical PR (PR with late surgery) (DFS P value 0.02, DSS P value 0.1). Our results confirm that CT alone can induce prolonged DFS in rare pa tients with advanced STS. In patients subjected to surgery, a good his tological response indicates improved outcome. (C) 1997 Elsevier Scien ce Ltd.