Histologic Alterations from Neoadjuvant Chemotherapy in High-Grade Extremity Soft Tissue Sarcoma: Clinicopathological Correlation

Histologicresponsetochemotherapyisgenerallyregarded as an independent prognostic variable in bone sarcomas, both osteosarcoma and Ewing’s sarcoma. In soft tissue sarcomas, however, descriptions of histologic alterations from chemotherapy and correlative outcome studies are much more limited. Herein we report clinicopathological findings from a homogeneously treated group of 31 patients with tumor stage T2 grade 3 extremity soft tissue sarcomas treated with the same neoadjuvant chemotherapy followed by surgical excision, treated by the same medical oncologist and orthopedic surgeon. Histologic response to therapy was evaluated by multiple parameters using a semiquantitative grading system. Based upon the percentage of post-treatment viable tumor, tumors were arbitrarily categorized similarly to Huvos score as showing excellent ( 50% viability) responses. Nineteen percent had excellent, 10% had moderate, and 71% had poor responses. These histologic response groups did not correlate with overall or event-free survival. For example, of