P A Cassier1, G Kantor2, S Bonvalot3, E Lavergne4, E Stoeckle5, C Le Péchoux6, P Meeus7, M-P Sunyach8, G Vaz9, J-M Coindre10, C Linassier11, A Labib12, C Delcambre13, J-O Bay14, S Leyvraz15, T Dubergé16, J-L Lagrange17, A Duret18, J-Y Blay19. 1. Department of Medical Oncology, Centre Léon Bérard, Lyon INSERM UMR5286, Centre de Recherche en Cancérologie de Lyon, Université de Lyon, Lyon cassierp@hotmail.com. 2. Department of Radiotherapy, Institut Bergonié, Bordeaux. 3. Department of Surgery, Institut Gustave Roussy, Villejuif. 4. Department of Biostatistics, Centre Léon Bérard, Lyon. 5. Department of Surgery, Institut Bergonié, Bordeaux. 6. Department of Radiotherapy, Institut Gustave Roussy, Villejuif. 7. Department of Surgery. 8. Department of Radiotherapy, Centre Léon Bérard, Lyon. 9. Department of Surgery, Hopital Edouard Herriot, Lyon. 10. Department of Pathology, Institut Bergonié, Bordeaux. 11. Department of Medical Oncology, Centre Hospitalier Universitaire, Tours. 12. Department of Radiotherapy, Institut Curie, Paris. 13. Department of Medical Oncology, Centre François Balcesse, Caen. 14. Department of Medical Oncology, Centre Hospitalier Universitaire, Clermont Ferrand, France. 15. Department of Medical Oncology, Centre Hospitalier Universitaire, Lauzanne, Switzerland. 16. Department of Radiotherapy, Hôpital La Timone, Marseille. 17. Department of Radiotherapy, Hôpital Henri Mondor, Paris, France. 18. Department of Medical Oncology, Centre Léon Bérard, Lyon. 19. Department of Medical Oncology, Centre Léon Bérard, Lyon INSERM UMR5286, Centre de Recherche en Cancérologie de Lyon, Université de Lyon, Lyon.
Abstract
BACKGROUND: The role of adjuvant radiotherapy (RT) in the management of atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WD-LPS) remains controversial. METHODS: Two hundred eighty-three patients with operable ALT/WD-LPS, no history of previous cancer, chemotherapy (CT) or RT, treated between 1984 and 2011 registered in the Conticabase database were included and described. Overall (OS), progression-free survival (PFS) and time to local relapse (TTLR) were evaluated from the time of first treatment. RESULTS: Three of 20 centers enrolled 58% of the patients. Median age at diagnosis was 61 (range 25-94) years, 147 patients (52%) were males, 222 (78%) patients had their primary tumor located in an extremity while 36 (13%) and 25 (9%) had tumors involving the girdle and the trunk wall, respectively. The median size of primary tumors was 17 cm (range 2-48 cm). Adjuvant RT was given to 132 patients (47%). Patients who received adjuvant RT had larger tumors (P = 0.005), involving more often the distal limbs (P < 0.001). Use of adjuvant RT varied across centers and along the study period. Other characteristics were balanced between the two groups. Median follow-up was 61.7 months. None of the patients developed metastasis during follow-up. The 5-year local relapse-free survival rates were 98.3% versus 80.3% with and without adjuvant RT, respectively (P < 0.001). Once stratified on time period (before/after 2003), adjuvant RT, tumor site and margin status (R0 versus other) were independently associated with TTLR. No OS difference was observed (P = 0.105). CONCLUSION: In this study, adjuvant RT following resection of ALT/WD-LPS was associated with a reduction of LR risk.
BACKGROUND: The role of adjuvant radiotherapy (RT) in the management of atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WD-LPS) remains controversial. METHODS: Two hundred eighty-three patients with operable ALT/WD-LPS, no history of previous cancer, chemotherapy (CT) or RT, treated between 1984 and 2011 registered in the Conticabase database were included and described. Overall (OS), progression-free survival (PFS) and time to local relapse (TTLR) were evaluated from the time of first treatment. RESULTS: Three of 20 centers enrolled 58% of the patients. Median age at diagnosis was 61 (range 25-94) years, 147 patients (52%) were males, 222 (78%) patients had their primary tumor located in an extremity while 36 (13%) and 25 (9%) had tumors involving the girdle and the trunk wall, respectively. The median size of primary tumors was 17 cm (range 2-48 cm). Adjuvant RT was given to 132 patients (47%). Patients who received adjuvant RT had larger tumors (P = 0.005), involving more often the distal limbs (P < 0.001). Use of adjuvant RT varied across centers and along the study period. Other characteristics were balanced between the two groups. Median follow-up was 61.7 months. None of the patients developed metastasis during follow-up. The 5-year local relapse-free survival rates were 98.3% versus 80.3% with and without adjuvant RT, respectively (P < 0.001). Once stratified on time period (before/after 2003), adjuvant RT, tumor site and margin status (R0 versus other) were independently associated with TTLR. No OS difference was observed (P = 0.105). CONCLUSION: In this study, adjuvant RT following resection of ALT/WD-LPS was associated with a reduction of LR risk.
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