{"entity":{"id":"strass","kind":"trial","name":"STRASS (EORTC 62092)","aka":[],"tldr":"The first randomised trial in retroperitoneal sarcoma found that radiotherapy before surgery did not reduce recurrence in the abdomen, ending a decades-long debate for most patients.","summary":"STRASS, EORTC 62092, randomised 266 patients with primary resectable retroperitoneal sarcoma across European and North American sarcoma centres to preoperative radiotherapy followed by surgery or surgery alone. Its primary endpoint of abdominal recurrence-free survival was not improved by radiotherapy, and preoperative treatment added toxicity and delayed surgery. An unplanned subgroup analysis suggested a benefit in well-differentiated and low-grade dedifferentiated liposarcoma, which continues to be studied but did not change the primary result. Published in Lancet Oncology in 2020, it made surgery alone the standard for most retroperitoneal sarcomas and shifted attention to neoadjuvant chemotherapy (STRASS2).","status":"negative","asOf":"2026-09-17","links":[{"label":"ClinicalTrials.gov NCT01344018","url":"https://clinicaltrials.gov/study/NCT01344018"},{"label":"Lancet Oncology 2020","url":"https://doi.org/10.1016/S1470-2045(20)30446-0"}],"tags":["subtype-page"],"related":[],"cancers":["retroperitoneal-sarcoma","liposarcoma","leiomyosarcoma","sarcoma"],"sections":[],"technologies":["imrt-igrt"],"targets":[],"drugs":[],"companies":["curie-nki-eortc"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT01344018","phase":"3","setting":"Primary resectable retroperitoneal sarcoma: preoperative radiotherapy (50.4 Gy) plus surgery versus surgery alone","sponsor":"EORTC","result":"Abdominal recurrence-free survival not improved by preoperative radiotherapy; possible benefit in liposarcoma subgroups only.","started":"2012-01","startedType":"actual","yearReported":2020,"enrolled":266,"enrolledBasis":"registry","outcomes":[{"endpoint":"Abdominal recurrence-free survival (median)","primary":true,"unit":"years","arms":[{"name":"Preoperative radiotherapy + surgery","n":133,"value":4.5,"note":"95% CI 3.9 to not estimable; median follow-up 43.1 months"},{"name":"Surgery alone","n":133,"value":5,"note":"95% CI 3.4 to not estimable"}],"hr":1.01,"ci":[0.71,1.44],"p":"0.95","source":"https://doi.org/10.1016/S1470-2045(20)30446-0"},{"endpoint":"Completed allocated treatment","unit":"%","arms":[{"name":"Preoperative radiotherapy + surgery","n":133,"value":89,"note":"Had both radiotherapy and surgery"},{"name":"Surgery alone","n":133,"value":96,"note":"Had surgery"}],"source":"https://doi.org/10.1016/S1470-2045(20)30446-0"},{"endpoint":"Grade 3-4 lymphopenia","unit":"%","arms":[{"name":"Preoperative radiotherapy + surgery","n":127,"value":77},{"name":"Surgery alone","n":128,"value":1}],"source":"https://doi.org/10.1016/S1470-2045(20)30446-0"},{"endpoint":"Grade 3-4 anaemia","unit":"%","arms":[{"name":"Preoperative radiotherapy + surgery","n":127,"value":12},{"name":"Surgery alone","n":128,"value":8}],"source":"https://doi.org/10.1016/S1470-2045(20)30446-0"},{"endpoint":"Grade 3-4 hypoalbuminaemia","unit":"%","arms":[{"name":"Preoperative radiotherapy + surgery","n":127,"value":12},{"name":"Surgery alone","n":128,"value":4}],"source":"https://doi.org/10.1016/S1470-2045(20)30446-0"},{"endpoint":"Serious adverse events","unit":"%","arms":[{"name":"Preoperative radiotherapy + surgery","n":127,"value":24},{"name":"Surgery alone","n":128,"value":10}],"source":"https://doi.org/10.1016/S1470-2045(20)30446-0"},{"endpoint":"Treatment-related deaths","unit":"%","arms":[{"name":"Preoperative radiotherapy + surgery","n":127,"value":1,"note":"One death from gastropleural fistula"},{"name":"Surgery alone","n":128,"value":0}],"source":"https://doi.org/10.1016/S1470-2045(20)30446-0"}]},"route":"/trials/strass/","neighbours":{"cancer":[{"id":"leiomyosarcoma","kind":"cancer","name":"Leiomyosarcoma","route":"/cancers/leiomyosarcoma/"},{"id":"liposarcoma","kind":"cancer","name":"Liposarcoma","route":"/cancers/liposarcoma/"},{"id":"retroperitoneal-sarcoma","kind":"cancer","name":"Retroperitoneal sarcoma","route":"/cancers/retroperitoneal-sarcoma/"},{"id":"sarcoma","kind":"cancer","name":"Sarcomas (soft tissue, bone, GIST)","route":"/cancers/sarcoma/"}],"technology":[{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"}],"company":[{"id":"curie-nki-eortc","kind":"company","name":"EORTC","route":"/companies/curie-nki-eortc/"}],"paper":[{"id":"paper-strass-lancet-oncol-2020","kind":"paper","name":"STRASS (EORTC 62092): preoperative radiotherapy plus surgery versus surgery alone for primary retroperitoneal sarcoma","route":"/key-papers/paper-strass-lancet-oncol-2020/"}]}}