Single-Agent Doxorubicin Adjuvant Chemotherapy for Resectable Grade 2/3 Soft Tissue Sarcomas: A Retrospective Study

Soft tissue sarcomas (STS) are rare but aggressive tumors. Although surgery and radiotherapy are standard treatments for localized STS, the role of adjuvant chemotherapy, particularly doxorubicin, in high-grade STS is debated.

This retrospective study evaluated the effectiveness of single-agent doxorubicin in resectable grade 2 and 3 STS, with a focus on oncologic outcomes. Adults with biopsy-confirmed STS of the extremities or trunk, treated at a tertiary center in Taiwan between January 2004 and March 2020, were included. Primary outcomes were distant metastasis-free survival (DMFS) and overall survival (OS).

The study enrolled 62 patients in either the single-agent doxorubicin adjuvant chemotherapy group (n = 8) or the observation-only group (n = 54). The mean age was 45.4 years in the adjuvant chemotherapy group and 58.2 years in the observation-only group. The 3-year OS was 100% in the chemotherapy group and 60% in the observation group (log-rank P = .064). The 3-year DMFS rate was 75% in the chemotherapy group and 45% in the observation group (log-rank P = .078).

In resectable, high-grade STS of 8 cm or more, single-agent doxorubicin as adjuvant chemotherapy showed a trend toward improved OS and DMFS compared with observation alone; however, statistical significance was not reached.