{"entity":{"id":"paper-strass-lancet-oncol-2020","kind":"paper","name":"STRASS (EORTC 62092): preoperative radiotherapy plus surgery versus surgery alone for primary retroperitoneal sarcoma","aka":[],"tldr":"Adding radiotherapy before surgery for retroperitoneal sarcoma did not improve abdominal recurrence-free survival overall, so it is no longer routine, though a possible benefit in liposarcoma keeps it under discussion.","summary":"Phase 3 trial of 266 patients with primary resectable retroperitoneal sarcoma randomised to preoperative radiotherapy (50.4 Gy) followed by surgery or surgery alone.\n\nMedian abdominal recurrence-free survival was 4.5 versus 5.0 years (hazard ratio 1.01), with more serious adverse events in the radiotherapy group; exploratory analysis suggested benefit in well-differentiated and low-grade dedifferentiated liposarcoma but not leiomyosarcoma.","asOf":"2026-09-17","links":[{"label":"Lancet Oncol 2020","url":"https://doi.org/10.1016/S1470-2045(20)30446-0"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/32941794/"}],"tags":[],"related":[],"cancers":["retroperitoneal-sarcoma","liposarcoma"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["strass"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet-oncology"],"dependsOn":[],"notes":[],"journal":"The Lancet Oncology","year":2020,"doi":"10.1016/S1470-2045(20)30446-0","pmid":"32941794","authors":"Bonvalot S, Gronchi A, Le Péchoux C, et al.","paperType":"rct","findings":["Median abdominal recurrence-free survival 4.5 vs 5.0 years; hazard ratio 1.01.","Serious adverse events 24 percent vs 10 percent."],"whatItMeans":"Surgery alone in a reference centre is the standard for primary retroperitoneal sarcoma; preoperative radiotherapy is considered case by case in liposarcoma.","caveats":["Trial did not meet its endpoint, but the liposarcoma subgroup signal remains debated.","Surgery-alone arm had excellent outcomes at expert centres."],"changedPractice":true,"participants":266},"route":"/key-papers/paper-strass-lancet-oncol-2020/","neighbours":{"cancer":[{"id":"liposarcoma","kind":"cancer","name":"Liposarcoma","route":"/cancers/liposarcoma/"},{"id":"retroperitoneal-sarcoma","kind":"cancer","name":"Retroperitoneal sarcoma","route":"/cancers/retroperitoneal-sarcoma/"}],"trial":[{"id":"strass","kind":"trial","name":"STRASS (EORTC 62092)","route":"/trials/strass/"}],"journal":[{"id":"lancet-oncology","kind":"journal","name":"The Lancet Oncology","route":"/journals/lancet-oncology/"}]}}