STRASS / EORTC-62092

Does preoperative RT improve abdominal recurrence-free survival in primary retroperitoneal sarcoma?

Population and treatment

266 patients randomized, 133 per arm.

Intervention vs comparator: Preoperative RT 50.4 Gy in 28 fractions followed by surgery vs surgery alone.

Registry: https://pubmed.ncbi.nlm.nih.gov/?term=STRASS+retroperitoneal+sarcoma+Lancet+Oncology

Results

Median abdominal recurrence-free survival 4.5 vs 5.0 years; HR 1.01 (95% CI 0.71–1.44; p=0.95). Grade 3–4 lymphopenia 77% vs 1%; serious AEs 24% vs 10%; one treatment-related death in RT arm.

Abdominal recurrence-free survival · Median follow-up / primary analysis

NNT: NCT01344018

NNH not calculated without a defensible fixed-time excess-harm risk. Never derive NNT from median survival or HR alone.

Toxicity and treatment burden

5

Full grade 3–5 toxicity, discontinuation, QoL and treatment exposure require primary-report/supplement extraction before full clinical signoff. Missing rates are not imputed.

Interpretation and limitations

Overall trial did not show benefit from routine preoperative RT. Histology-specific signals require separate interpretation; no NNT for the negative overall result.

Distinguish prespecified from exploratory subgroups, mature from immature endpoints, and superiority from non-inferiority. Verify current guidelines and eligibility.

Primary source

Primary publication / authoritative source ↗

Source-level QoL, discontinuation, full toxicity and guideline currency audit remains a QC requirement.