{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:15:53Z","timestamp":1792718153909,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005972","name":"Deutsche Krebshilfe","doi-asserted-by":"publisher","award":["T 9\/96\/Tr I"],"award-info":[{"award-number":["T 9\/96\/Tr I"]}],"id":[{"id":"10.13039\/501100005972","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005972","name":"Deutsche Krebshilfe","doi-asserted-by":"publisher","award":["50\u20102721\u2010Tr2"],"award-info":[{"award-number":["50\u20102721\u2010Tr2"]}],"id":[{"id":"10.13039\/501100005972","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood & Cancer"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Here we report the results of the first comprehensive European trials for all soft tissue sarcoma entities, which aimed to develop a new risk stratification system, limit radiotherapy and chemotherapy for low\u2010\/standard\u2010risk patients, and evaluate different chemotherapy regimens for high\u2010risk patients.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n The prospective CWS\u201096 and CWS\u20102002P trials stratified patients with non\u2010rhabdomyosarcoma soft tissue sarcoma (NRSTS) by\n Intergroup Rhabdomyosarcoma Study<\/jats:italic>\n (IRS) group, histology and grade (CWS\u201096) or IRS group, lymph node status, tumour histology and size (CWS\u20102002P). Low\u2010risk patients received no additional treatment. Standard\u2010risk patients were treated with 44.8\u00a0Gy radiotherapy, and in CWS\u201096, adjuvant chemotherapy was added for high\u2010grade tumours (vincristine, actinomycin\u2010D, ifosfamide, 160\u2013240\u00a0mg\/m\n 2<\/jats:sup>\n adriamycin\/VAIA). High\u2010risk patients received VAIA in CWS\u201096 or an intensified adriamycin regimen in CWS\u20102002P (VAIA\u2010III, 320\u00a0mg\/m\n 2<\/jats:sup>\n adriamycin), resection and\/or 44.8\u00a0Gy radiotherapy, followed by maintenance treatment with cyclophosphamide and vinblastine in certain NRSTS in CWS\u20102002P. The trials enrolled 1249 patients with localised NRSTS, of whom 483 (CWS\u201096) and 445 (CWS\u20102002P) were eligible for survival analysis. Histological classifications were retrospectively standardised, including recent data from the soft tissue sarcoma registry.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Overall survival (OS) was significantly improved (5\u2010year OS: 81% vs. 73%,\n p<\/jats:italic>\n = 0.024) for patients treated in CWS\u20102002P compared to CWS\u201096, partly explained by the inclusion of more low\u2010grade entities in CWS\u20102002P. The higher anthracycline dose in the VAIA\u2010III regimen (CWS\u20102002P) did not improve survival (EFS:\n p<\/jats:italic>\n = 0.23, OS:\n p<\/jats:italic>\n = 0.73; matched pairs analysis). Re\u2010classification revealed a higher proportion of malignant entities according to WHO in CWS\u201096 compared to CWS\u20102002P (90% vs. 81%,\n p<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Complete resection alone is sufficient to cure low\u2010risk NRSTS. Survival was not improved by dose\u2010intensified adjuvant chemotherapy (with\/without maintenance treatment). Patients with completely resected high\u2010risk disease may not profit from adjuvant radiotherapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pbc.32159","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T11:39:27Z","timestamp":1762861167000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Children and Adolescents With Localised Non\u2010Rhabdomyosarcoma Soft Tissue Sarcoma: Results of the CWS\u201096 and CWS\u20102002P Prospective Trials With Reclassification of the Trial Data Incorporating the Recent Soft Tissue Sarcoma Registry"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3472-9679","authenticated-orcid":false,"given":"Amadeus T.","family":"Heinz","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology and Oncology University Children\u00b4s Hospital Tuebingen Tuebingen Germany"},{"name":"Stuttgart Cancer Center Zentrum F\u00fcr Kinder\u2010, Jugend\u2010 und Frauenmedizin (Olgahospital), P\u00e4diatrie 5 (P\u00e4diatrische Onkologie, H\u00e4matologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Sch\u00f6nstein","sequence":"additional","affiliation":[{"name":"Network Aging Research Heidelberg University Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Koscielniak","sequence":"additional","affiliation":[{"name":"Stuttgart Cancer Center Zentrum F\u00fcr Kinder\u2010, Jugend\u2010 und Frauenmedizin (Olgahospital), P\u00e4diatrie 5 (P\u00e4diatrische Onkologie, H\u00e4matologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart Stuttgart Germany"},{"name":"Medical Faculty Tuebingen Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4229-8058","authenticated-orcid":false,"given":"Martin","family":"Ebinger","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology University Children\u00b4s Hospital Tuebingen Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology University Children's Hospital Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semi","family":"Harrabi","sequence":"additional","affiliation":[{"name":"Department of Radiooncology and Radiotherapy Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4138-4536","authenticated-orcid":false,"given":"Christian","family":"Vokuhl","sequence":"additional","affiliation":[{"name":"Department of Pathology Section of Pediatric Pathology Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Imle","sequence":"additional","affiliation":[{"name":"Hopp Children's Cancer Center (KiTZ) Heidelberg Germany"},{"name":"Heidelberg Faculty of Medicine, Department of Pediatric Oncology, Hematology and Immunology Heidelberg University Heidelberg Germany"},{"name":"Division of Pediatric Neurooncology German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"Soft Tissue Sarcoma Research Group (B380), German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"National Center for Tumor Diseases (NCT) NCT Heidelberg, a Partnership Between DKFZ and Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7281-8811","authenticated-orcid":false,"given":"Sabine","family":"Stegmaier","sequence":"additional","affiliation":[{"name":"Stuttgart Cancer Center Zentrum F\u00fcr Kinder\u2010, Jugend\u2010 und Frauenmedizin (Olgahospital), P\u00e4diatrie 5 (P\u00e4diatrische Onkologie, H\u00e4matologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines B.","family":"Brecht","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology University Children\u00b4s Hospital Tuebingen Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustaf","family":"Ljungman","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University, and Pediatric Oncology, Children's University Hospital Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Juntti","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescence Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Ladenstein","sequence":"additional","affiliation":[{"name":"St. Anna Kinderkrebsforschung Wien Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernarda","family":"Kazanowska","sequence":"additional","affiliation":[{"name":"Department of Pediatric Bone Marrow Transplantation, Oncology, and Hematology Wroclaw Medical University Wroclaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Klingebiel","sequence":"additional","affiliation":[{"name":"Department of Children and Adolescents University Hospital of Frankfurt Goethe University Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian W.","family":"Pajtler","sequence":"additional","affiliation":[{"name":"Hopp Children's Cancer Center (KiTZ) Heidelberg Germany"},{"name":"Heidelberg Faculty of Medicine, Department of Pediatric Oncology, Hematology and Immunology Heidelberg University Heidelberg Germany"},{"name":"Division of Pediatric Neurooncology German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"National Center for Tumor Diseases (NCT) NCT Heidelberg, a Partnership Between DKFZ and Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9551-2399","authenticated-orcid":false,"given":"Monika","family":"Sparber\u2010Sauer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology University Children\u00b4s Hospital Tuebingen Tuebingen Germany"},{"name":"Stuttgart Cancer Center Zentrum F\u00fcr Kinder\u2010, Jugend\u2010 und Frauenmedizin (Olgahospital), P\u00e4diatrie 5 (P\u00e4diatrische Onkologie, H\u00e4matologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(21)00159-0"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30672-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29691"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.02.5577"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.03.209"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2022.11.008"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","unstructured":"A. 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M.","year":"1995","journal-title":"Modern Pathology"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.12.3706"},{"key":"e_1_2_9_21_1","volume-title":"WHO Classification of Tumours of Soft Tissue and Bone: WHO Classification of Tumours, Vol. 5","author":"Fletcher C.","year":"2013"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/pst.433"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy167"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S368381"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9061752"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.02673"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102957"}],"container-title":["Pediatric Blood & Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.32159","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pbc.32159","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.32159","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:36:14Z","timestamp":1790242574000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.32159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,11]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/pbc.32159"],"URL":"https:\/\/doi.org\/10.1002\/pbc.32159","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,11]]},"assertion":[{"value":"2025-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e32159"}}