BACKGROUND: Patients with large, high-grade extremity and truncal soft tissue 
sarcomas (STS) are at considerable risk for recurrence. A regimen of 
pre-operative chemotherapy consisting of mesna, adriamycin, ifosfamide and 
dacarbazine (MAID), interdigitated with radiotherapy (RT), followed by resection 
and post-operative chemotherapy with or without RT, has demonstrated high rates 
of local and distant control. The goal of this study is to assess outcomes in a 
recent cohort of patients treated on this regimen.
METHODS: We retrospectively reviewed records of 66 consecutive patients with STS 
of the extremity or trunk who were treated with the aforementioned regimen from 
May 2000 to April 2011. Clinicopathologic characteristics and patient outcomes 
were analysed.
RESULTS: Sixty-six patients were analysed and were equally divided between grade 
2 and 3 tumours. Margins were negative in 57 (89%) patients and positive in 
seven (11%) patients. At a median follow-up of 46 months, there were six (9%) 
locoregional and 20 (30%) distant recurrences. The locoregional and distant 
5-year recurrence-free survival (RFS) rates were 91% and 64%, respectively. The 
5-year overall (OS) and disease-specific survival rates were 86% and 89%, 
respectively. There were no treatment-related deaths or secondary 
myelodysplasias. Thirty-four (52%) patients had grade 3 or 4 acute haematologic 
chemotherapy-related toxicity. There were no statistically significant 
predictors of OS or RFS.
CONCLUSIONS: For a contemporary cohort of patients with high-risk extremity and 
truncal STS, a regimen of neoadjuvant chemoradiotherapy and surgery continues to 
result in high rates of survival with tolerable short- and long-term toxicity.