title: Effect of adjuvant chemotherapy on survival in FNCLCC grade 3 soft tissue sarcomas: a multivariate analysis of the French Sarcoma Group Database.
abstract: BACKGROUND
  The predictive value of grade for benefit from adjuvant chemotherapy (AC) in soft tissue sarcoma (STS) patients has never been explored.
  
  
  METHODS
  From 1980 to 1999, 1513 adult patients with non-metastatic STS were included prospectively in the French Sarcoma Group database. Grade was assessed according to the Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) system after central review.
  
  
  RESULTS
  AC was delivered to 13 grade 1 patients (3%), 145 grade 2 patients (35%) and 262 grade 3 patients (62%). Young age, non-well-differentiated liposarcoma histology, deep location, bone and/or neurovascular invasion and grade 2 or 3 were significantly associated with a higher likelihood to receive AC. Median follow-up was 9 years. On multivariate analysis, AC was significantly associated with improved metastasis-free survival (MFS) [5-year MFS: 58% versus 49%, hazard ratio (HR) 0.7 (95% confidence interval (CI) 0.6-0.9), P = 0.01] and overall survival (OS) [5-year OS: 58% versus 45%, HR 0.6 (95% CI 0.5-0.8), P = 0.0002] in grade 3 patients. This was not observed in grade 2 patients [5-year MFS: 76% versus 73%, HR 0.8 (95% CI 0.5-1.2), P = 0.27; 5-year OS: 75% versus 65%, HR 0.8 (95% CI 0.6-1.1), P = 0.15].
  
  
  CONCLUSIONS
  This large cohort-based analysis with long-term follow-up indicates that patients with FNCLCC grade 3 disease may benefit from AC.
authors.affiliation: Department of Medical Oncology, Institut Bergonié, Bordeaux. Electronic address: italiano@bergonie.org.
authors.forename: A
authors.initials: A
authors.lastname: Italiano
authors.affiliation: INSERM CIC-EC7, Université Victor Ségalen, Bordeaux; Clinical Research Unit, Institut Bergonié, Bordeaux.
authors.forename: F
authors.initials: F
authors.lastname: Delva
authors.affiliation: INSERM CIC-EC7, Université Victor Ségalen, Bordeaux; Clinical Research Unit, Institut Bergonié, Bordeaux.
authors.forename: S
authors.initials: S
authors.lastname: Mathoulin-Pelissier
authors.affiliation: Department of Medecine.
authors.forename: A
authors.initials: A
authors.lastname: Le Cesne
authors.affiliation: Department of Surgery.
authors.forename: S
authors.initials: S
authors.lastname: Bonvalot
authors.affiliation: Department of Pathology, Institut Gustave Roussy, Villejuif.
authors.forename: P
authors.initials: P
authors.lastname: Terrier
authors.affiliation: Department of Pathology, Centre René Huguenin, Saint-Cloud.
authors.forename: M
authors.initials: M
authors.lastname: Trassard
authors.affiliation: Department of Pathology, Centre François Baclesse, Caen.
authors.forename: J-J
authors.initials: JJ
authors.lastname: Michels
authors.affiliation: Department of Medicine, Centre Léon Bérard, Lyon.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Blay
authors.affiliation: Department of Pathology, Institut Bergonie, Bordeaux, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Coindre
authors.affiliation: Department of Medical Oncology, Institut Bergonié, Bordeaux.
authors.forename: B
authors.initials: B
authors.lastname: Bui
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D016208:Databases, Factual; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012107:Research Design; D012509:Sarcoma / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D016019:Survival Analysis; D055815:Young Adult