Histopathological Response After Neoadjuvant Chemotherapy for High-Risk Soft-Tissue Sarcomas

Does histopathological response after neoadjuvant chemotherapy (NACT) estimate outcomes in patients with high-risk soft-tissue sarcoma (STS) of extremity or trunk wall?In this preplanned secondary analysis of a clinical trial involving 388 patients, the proportion of stainable tumor cells was not associated with disease-free survival (DFS). Necrosis was associated with worse DFS, and presence of sclerohyalinosis greater than 20% estimated improved DFS.These findings suggest that the presence of sclerohyalinosis may serve as a novel histopathological marker of favorable response to NACT in STS, challenging the current emphasis on the proportion of stainable tumor cells and informing patient risk stratification and treatment evaluation.

Corresponding Authors: Paola Collini, MD, Soft Tissue Tumor Pathology Unit, Department of Advanced Diagnostics (paola.collini@istitutotumori.mi.it); Alessandro Gronchi, MD, Sarcoma Service, Department of Surgery (alessandro.gronchi@istitutotumori.mi.it), Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.

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