This protocol addresses patients with localized high-grade (G2 or G3) fibrosarcoma who have completed first-line multimodal treatment but whose surgical resection did not yield histologically tumour-free (R0) margins — the key criterion for adequate local control.
The first-line approach — neoadjuvant MAID chemotherapy (mesna, doxorubicin, ifosfamide, dacarbazine) followed by wide surgical resection, with adjuvant radiation therapy considered for deep tumours exceeding 5 cm — did not achieve its primary surgical goal: histologically tumour-free (R0) resection margins. This unmet goal is the trigger for the next-line protocol described here.
Where technically feasible, the protocol calls for a further surgical intervention aimed at obtaining clear margins. The full criteria, eligibility conditions, and procedural guidance are available in the complete protocol.
Achieving histological tumour-free resection margins (R0) to minimise the risk of local recurrence.