Impact of neoadjuvant chemotherapy on postoperative morbidity in soft tissue sarcomas

Purpose: The purpose of this study well to test the hypothesis that neoadju vant chemotherapy (NeoCT) does not increase morbidity in patients undergoin g radical surgery for soft tissue sarcomas. Patients and Methods: The records of 309 patients who presented to The Univ ersity of Texas M,D, Anderson Cancer Center for definitive surgical managem ent of primary soft tissue sarcomas were retrospectively reviewed. One hund red five patients who received NeoCT were compared with 204 patients who ha d surgery first (Surg), Patients had extremity sarcomas (71 NeoCT patients and 130 Surg patients) or retroperitoneal/visceral sarcomas (34 NeoCT and 7 4 Surg), Results: NeoCT patients had larger tumors (median, 12 v 8 cm), more frequen tly had high-grade tumors (90% v 64%), and were younger (median age 47 v 55 years). The incidence of surgical complications was not different for NeoC T patients than for Surg patients, both in those with extremity sarcomas (3 4% v 41%) and in those with retroperitoneal/visceral sarcomas (29% v 34%), The most common complications were wound infections and other wound complic ations, Preoperative radiation therapy autologous flap coverage, and extrem ity tumors were associated with increased wound complications. No significa nt differences in length of hospital stay, rate of readmission, or rate of reoperation for complications were found between the NeoCT and Surg groups. One of the three postoperative deaths in our series occurred in the NeoCT group. Conclusion: In this retrospective review, there was no evidence that NeoCT increased postoperative morbidity in patients with soft tissue sarcomas. Pr ospective, randomized studies are needed to confirm these results. J Clin O ncol 18:3378-3383, (C) 2000 by American Society of Clinical Oncology.