Adjuvant chemotherapy in the treatment of soft-tissue sarcoma

Standard therapy for treatment of soft-tissue sarcoma dictates adequate surgical resection with or without radiation therapy. However, metastases occur in a substantial proportion of cases, and, if improvement in survival is to be obtained, elimination of hematogenously borne micrometastasis will be required. A number of randomized, controlled clinical trials have been performed evaluating the use of cytotoxic chemotherapy in the treatment of localized soft-tissue sarcoma. Single-arm studies evaluating the use of intraarterial chemotherapy as an adjunct to limb-sparing surgery have been reported. Many of these studies have methodologic weaknesses, and have yielded conflicting results. Reviewed in detail, these studies are evaluated in the light of opportunities for clinical research.