Radiotherapy and extent of surgical resection in retroperitoneal soft‐tissue sarcoma: Multi‐institutional analysis of 261 patients
2010; Wiley; Volume: 101; Issue: 5 Linguagem: Inglês
10.1002/jso.21474
ISSN1096-9098
AutoresSagus Sampath, Ying J. Hitchcock, Dennis C. Shrieve, R. Lor Randall, Timothy E. Schultheiss, Jeffrey Y.C. Wong,
Tópico(s)Cardiac tumors and thrombi
ResumoAbstract Background and Objective To examine the impact of adjuvant radiotherapy (RT) and surgical technique on survival in retroperitoneal soft‐tissue sarcoma. Methods A retrospective analysis was conducted using the National Oncology Database, a proprietary database of aggregated tumor registries owned by IMPAC® Medical Systems (Sunnyvale, CA). Patients who received definitive surgery with negative or microscopic‐positive margins were included. Multivariate analysis was performed using the Cox proportional hazards model. Survival curves were estimated by the Kaplan–Meier method and were compared for statistical significance ( P < 0.05) using the log‐rank test. Results Two hundred sixty‐one patients met inclusion criteria. The median follow‐up was 59 months (range 0.2–186 months). The 5‐year cause‐specific survival (CSS) and local failure‐free survival (LFFS) were 73% and 66%, respectively. Grade, margin status, and histology were independent predictors for CSS ( P < 0.05). Adjuvant RT was associated with a significant improvement in LFFS over surgery alone (hazard ratio = 0.42, 95% confidence interval 0.21–0.86, P < 0.05). Patients receiving simple excision and RT had a 5‐year LFFS of 88%, significantly higher than wide resection with or without RT (log‐rank, P < 0.05). Conclusion Adjuvant RT is associated with a lower risk of local relapse compared to surgery alone. The impact of surgical technique on adjuvant RT efficacy warrants further study. J. Surg. Oncol. 2010; 101:345–350. © 2010 Wiley‐Liss, Inc.
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