Background/Objectives:The relationship between pathologic findings in soft tissue sarcoma (STS) after neoadjuvant treatment and oncological outcomes remains uncertain due to varying evaluation methods and cut-off values. This study aims to assess pathologic findings after neoadjuvant radiotherapy in STS using the EORTC-STBSG response score and evaluate its prognostic value.Methods:Clinical and outcome data from 44 patients were reviewed. Resected specimens were re-evaluated to measure viable cells, necrosis, fibrosis, and hyalinization. Local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) were analyzed using Kaplan–Meier survival analysis. Cox proportional hazards regression was used for univariate and multivariate analyses to correlate outcomes with pathologic response.Results:The median percentages of viable cells, necrosis, and fibrosis/hyalinization were 20%, 11%, and 40%, respectively. A pathologic complete response (pCR), defined as ≤5% viable cells, was achieved in 25% of cases. Local recurrence occurred in 33% of cases, with a significantly higher rate of 64% after R1 resection compared to 22% after R0 resection. Distant metastases were observed in 42% of patients, primarily in the lungs. The 3-year rates for LRFS, DMFS, and OS were 65%, 54%, and 67%, respectively. A correlation between outcomes and tumor size, grade and histological subtype was observed. Classifying pathologic response by the EORTC-STBSG score failed to show an association with outcomes. Patients achieving pCR showed lower risk of LR and improved OS.Conclusions:While the EORTC-STBSG score did not show a prognostic value, resection specimens with ≤5% viable cells were linked to improved LRFS and OS.
背景/目的：软组织肉瘤（STS）新辅助治疗后病理学表现与肿瘤学结局之间的关系因评估方法和临界值不同而存在不确定性。本研究旨在采用EORTC-STBSG反应评分系统评估STS新辅助放疗后的病理学表现，并评价其预后价值。 方法：回顾性分析44例患者的临床及预后资料。对切除标本进行重新评估，测量存活细胞、坏死、纤维化及玻璃样变比例。采用Kaplan-Meier生存分析法评估局部无复发生存期（LRFS）、无远处转移生存期（DMFS）和总生存期（OS）。通过Cox比例风险回归模型进行单因素和多因素分析，探究病理学反应与预后的相关性。 结果：存活细胞、坏死及纤维化/玻璃样变的中位百分比分别为20%、11%和40%。25%的病例达到病理完全缓解（pCR，定义为存活细胞≤5%）。局部复发率为33%，其中R1切除后复发率（64%）显著高于R0切除（22%）。42%的患者发生远处转移，主要转移部位为肺部。3年LRFS、DMFS和OS率分别为65%、54%和67%。研究观察到肿瘤大小、分级及组织学亚型与预后存在相关性。按EORTC-STBSG评分划分的病理学反应分级与预后无显著关联。达到pCR的患者局部复发风险更低，总生存期更优。 结论：虽然EORTC-STBSG评分未显示预后价值，但存活细胞≤5%的切除标本与改善的LRFS和OS相关。
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