Lu E, et al. - The optimal treatment of high-risk soft tissue sarcomas (STS) of the extremities was assessed by reporting follow-up from a phase II study of dose-intense chemotherapy with pre-operative hypofractionated radiation in this population supplemented with subsequent data from an extensive institutional experience using this regimen. Favorable clinical outcomes were achieved with treatment with pre-operative radiation and pre- and post-operative epirubicin and ifosfamide. Survival and recurrence rates were comparable to those reported with other pre-operative chemotherapy regimens in high-risk extremity sarcomas. For appropriate high-risk STS patients, trimodality therapy is recommended.