{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:09:34Z","timestamp":1792696174142,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T00:00:00Z","timestamp":1634083200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The value of neoadjuvant chemotherapy in soft tissue sarcoma (STS) is not completely understood. This study investigated the benefit of neoadjuvant chemotherapy according to prognostic stratification based on the Sarculator nomogram for STS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study analyzed data from ISG\u2010STS 1001, a randomized study that tested 3 cycles of neoadjuvant anthracycline plus ifosfamide (AI) or histology\u2010tailored (HT) chemotherapy in adult patients with STS. The 10\u2010year predicted overall survival (pr\u2010OS) was estimated with the Sarculator and was stratified into higher (10\u2010year pr\u2010OS &lt; 60%) and lower risk subgroups (10\u2010year pr\u2010OS \u2265 60%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median pr\u2010OS was 0.63 (interquartile range [IQR], 0.51\u20100.72) for the entire study population, 0.62 (IQR, 0.51\u20100.70) for the AI arm, and 0.64 (IQR, 0.51\u20100.73) for the HT arm. Three\u2010 and 5\u2010year overall survival (OS) were 0.86 (95% confidence interval [CI], 0.82\u20100.93) and 0.81 (95% CI, 0.71\u20100.86) in lower risk patients and 0.69 (95% CI, 0.70\u20100.85) and 0.59 (95% CI, 0.51\u20100.72) in the higher risk patients (log\u2010rank test,\n                      <jats:italic>P<\/jats:italic>\n                      = .004). In higher risk patients, the 3\u2010 and 5\u2010year Sarculator\u2010predicted and study\u2010observed OS rates were 0.68 and 0.58, respectively, and 0.85 and 0.66, respectively, in the AI arm (\n                      <jats:italic>P<\/jats:italic>\n                      = .04); the corresponding figures in the HT arm were 0.69 and 0.60, respectively, and 0.69 and 0.55, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; .99). In lower risk patients, the 3\u2010 and 5\u2010year Sarculator\u2010predicted and study\u2010observed OS rates were 0.85 and 0.80, respectively, and 0.89 and 0.82, respectively, in the AI arm (\n                      <jats:italic>P<\/jats:italic>\n                      = .507); the corresponding figures in the HT arm were 0.87 and 0.81, respectively, and 0.86 and 0.74, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      = .105).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High\u2010risk patients treated with AI performed better than predicted, and this adds to the evidence for the efficacy of neoadjuvant AI in STS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay Summary<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>People affected by soft tissue sarcomas of the extremities and trunk wall are at some risk of developing metastasis after surgery.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Preoperative or postoperative chemotherapy has been tested in clinical trials to reduce the chances of distant metastasis. However, study findings have not been conclusive.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>This study stratified the risk of metastasis for people affected by sarcomas who were included in a clinical trial testing neoadjuvant chemotherapy. Exploiting the prognostic nomogram Sarculator, it found a benefit for chemotherapy when the predicted risk, based on patient and tumor characteristics, was high.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.33895","type":"journal-article","created":{"date-parts":[[2021,10,17]],"date-time":"2021-10-17T03:26:54Z","timestamp":1634441214000},"page":"85-93","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":107,"title":["Neoadjuvant chemotherapy in high\u2010risk soft tissue sarcomas: A Sarculator\u2010based risk stratification analysis of the ISG\u2010STS 1001 randomized trial"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4815-6293","authenticated-orcid":false,"given":"Sandro","family":"Pasquali","sequence":"first","affiliation":[{"name":"Department of Surgery Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3406-6705","authenticated-orcid":false,"given":"Emanuela","family":"Palmerini","sequence":"additional","affiliation":[{"name":"Osteoncology, Bone and Soft Tissue Sarcomas, and Innovative Therapies Unit IRCCS Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Quagliuolo","sequence":"additional","affiliation":[{"name":"Department of Surgery IRCCS Humanitas Research Hospital Rozzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Martin\u2010Broto","sequence":"additional","affiliation":[{"name":"Medical Oncology Department University Hospital Virgen del Rocio Seville Spain"},{"name":"Institute of Biomedicine of Seville University of Seville Seville Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Lopez\u2010Pousa","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine Hospital de la Santa Creu i Sant Pau Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5515-569X","authenticated-orcid":false,"given":"Giovanni","family":"Grignani","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2010IRCCS Candiolo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2583-5226","authenticated-orcid":false,"given":"Antonella","family":"Brunello","sequence":"additional","affiliation":[{"name":"Department of Oncology Medical Oncology 1 Unit Istituto Oncologico Veneto IRCCS Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7190-120X","authenticated-orcid":false,"given":"Jean\u2010Yves","family":"Blay","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine L\u00e9on B\u00e9rard Cancer Center Lyon France"},{"name":"Universit\u00e9 Claude Bernard Lyon I Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Tendero","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital Universitari Son Espases Palma de Mallorca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Diaz\u2010Beveridge","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine Hospital Universitari i Polit\u00e8cnic La Fe Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Ferraresi","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine Istituto Regina Elena Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwona","family":"Lugowska","sequence":"additional","affiliation":[{"name":"Department of Soft Tissue\/Bone Sarcoma and Melanoma Centrum Onkologii Instytut im Marii Sk\u0142odowskiej Curie Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Infante","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Trial Organization Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Braglia","sequence":"additional","affiliation":[{"name":"Research and Statistics Infrastructure Azienda Unit\u00e0 Sanitaria Locale\u2013IRCCS Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico Franco","family":"Merlo","sequence":"additional","affiliation":[{"name":"Research and Statistics Infrastructure Azienda Unit\u00e0 Sanitaria Locale\u2013IRCCS Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Fontana","sequence":"additional","affiliation":[{"name":"Clinical Trial Center and Department of Epidemiology IRCCS Azienda Ospedaliera Universitaria San Martino IST Istituto Nazionale per la Ricerca sul Cancro Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Marchesi","sequence":"additional","affiliation":[{"name":"Clinical Trial Center Italian Sarcoma Group Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide Maria","family":"Donati","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Oncology Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Palassini","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Oncology Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Marrari","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine Istituto Clinico Humanitas Rozzano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Morosi","sequence":"additional","affiliation":[{"name":"Department of Radiology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1742-8666","authenticated-orcid":false,"given":"Silvia","family":"Stacchiotti","sequence":"additional","affiliation":[{"name":"Department of Cancer Medicine Fondazione IRCCS Istituto Nazionale dei Tumori Milan 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