OVERALL SURVIVAL RATE AFTER NEOADJUVANT TREATMENT IN PATIENTS WITH SOFT TISSUE SARCOMA: AN EXPERIENCE OF AN ONCOLOGY CENTER BETWEEN YEARS 2016 TO 2021

Introduction: Although they represent only 1% of all cancers in adults, sarcomas are very aggressive. Objective: To evaluate the improvement in survival of adults diagnosed with soft tissue sarcoma undergoing neoadjuvant chemotherapy (NAC). Methods: Pilot, observational, analytical and retrospective study with patients diagnosed with soft tissue sarcoma, without metastasis, between 2016 and 2021 in an Oncology Center in the northeast of Brazil. The Chi-square and Fisher’s Exact tests were used to verify the existence of an association between the variables. The significance level considered was 5% (□ = 0.05). Survival curves for a recurrence-free time were estimated using the Kaplan-Meier curves, and were compared using log-rank test. Results: 53 patients were included. The median age was 48.6 years and 34 patients had stage III disease (64.2%). The most prevalent cancer was Leiomyosarcoma (24%) in women and Synovial Sarcoma in men (25%). 76.9% of patients underwent conservative surgery. 25% were treated with NAC and 52% with adjuvant chemotherapy (AC). 88.9% had adjuvant radiotherapy. Those who underwent conservative surgery had greater survival (p=0.017). There was local recurrence in 20.8% of patients and distant recurrence in 26.4%. After one year of complete treatment, patients had a 0.75 (75%) probability of being relapse-free, dropping to 59% at 5 years. The recurrence-free survival time for tumor size (p=0.021), staging (p=0.05), histological type (p=0.002) and type of surgery (p=0.017) were significant. The chance of patients who did not undergo NAC to develop a recurrence (local or distant) is 1.4 times greater than for patients who underwent NAC. By Cox regression, there was an 8.3-fold lower risk of recurrence for those who underwent NAC [HR = 0.91 (95% CI; 0.3 – 2.78; p=0.879)]. Conclusion: Although the small sample size, according to this study, NAC increased overall survival and recurrence-free time, and tumor size, staging, histological type, and type of surgery also impacted recurrence-free time.