R De Sanctis1,2, L Giordano3, C Colombo4, A De Paoli5, P Navarria6, C Sangalli7, A Buonadonna8, R Sanfilippo9, G Bertola10, M Fiore4, A Marrari11, F Navarria5, A Bertuzzi11, P G Casali9, S Basso10, A Santoro11,12, V Quagliuolo13, A Gronchi4. 1. Department of Medical Oncology and Hematology, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy. rita.de_sanctis@cancercenter.humanitas.it. 2. Molecular and Cellular Networks Lab, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, "Sapienza" University, Rome, Italy. rita.de_sanctis@cancercenter.humanitas.it. 3. Biostatistics Unit, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy. 4. Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 5. Department of Radiation Oncology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy. 6. Department of Radiotherapy and Radiosurgery, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy. 7. Department of Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 8. Department of Medical Oncology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy. 9. Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 10. Department of Surgical Oncology, Centro di Riferimento Oncologico, National Cancer Institute, Aviano, Italy. 11. Department of Medical Oncology and Hematology, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy. 12. Department of Biomedical Science, Humanitas University, Rozzano, Milan, Italy. 13. Department of Surgery, Humanitas Cancer Center and Research Hospital, IRCCS, Rozzano, Milan, Italy.
Abstract
BACKGROUND: This study was designed to assess patterns of recurrence and long-term outcomes of patients undergoing surgery for localized retroperitoneal sarcoma (RPS) after neoadjuvant high dose long-infusion ifosfamide (HLI) and radiotherapy (RT). METHODS: Patients received three cycles of HLI (14 g/m2). RT was started in combination with II cycle up to a total dose of 50.4 Gy. Surgery was scheduled 4-6 weeks after the end of RT. The primary endpoint was relapse-free survival (RFS) after surgery. Secondary endpoints were overall survival (OS), crude cumulative incidence of local recurrence (CCI-LR), and distant metastases (CCI-DM). For patients who relapsed, progression-free survival (PFS) and post-relapse OS were estimated. The trial was registered with ITASARC_*II_2004_003. RESULTS: Between 2003 and 2010, 83 patients were recruited. At a median follow-up of 91.7 months, 42 (56%) of 75 operated patients developed LR (n = 27) or DM (n = 10) or both LR and DM (n = 5) relapse. Seven-year RFS was 46.6% [95% confidence interval (CI) 29.6-52.4]. Thirty-two patients died. Seven-year OS rate was 63.2% (95% CI 42.7-66.0). The corresponding CCI of LR and DM were 37.4% [standard error (SE) 5.5%] and 20.0% (SE 12.6%), respectively. The only factor significantly associated with LR was FNCLCC grading, whereas histological subtype resulted associated with DM. At recurrence, 24 patients (57%) underwent surgery. Two-year post-relapse PFS and OS rates for patients developing LR or DM were 14.8, 41.0, 27.3, and 63.6%, respectively. CONCLUSIONS: LR after neoadjuvant CT-RT for RPS were predominantly infield. While almost one half of relapsed patients underwent further surgery, prognosis was poor.
BACKGROUND: This study was designed to assess patterns of recurrence and long-term outcomes of patients undergoing surgery for localized retroperitoneal sarcoma (RPS) after neoadjuvant high dose long-infusion ifosfamide (HLI) and radiotherapy (RT). METHODS:Patients received three cycles of HLI (14 g/m2). RT was started in combination with II cycle up to a total dose of 50.4 Gy. Surgery was scheduled 4-6 weeks after the end of RT. The primary endpoint was relapse-free survival (RFS) after surgery. Secondary endpoints were overall survival (OS), crude cumulative incidence of local recurrence (CCI-LR), and distant metastases (CCI-DM). For patients who relapsed, progression-free survival (PFS) and post-relapse OS were estimated. The trial was registered with ITASARC_*II_2004_003. RESULTS: Between 2003 and 2010, 83 patients were recruited. At a median follow-up of 91.7 months, 42 (56%) of 75 operated patients developed LR (n = 27) or DM (n = 10) or both LR and DM (n = 5) relapse. Seven-year RFS was 46.6% [95% confidence interval (CI) 29.6-52.4]. Thirty-two patients died. Seven-year OS rate was 63.2% (95% CI 42.7-66.0). The corresponding CCI of LR and DM were 37.4% [standard error (SE) 5.5%] and 20.0% (SE 12.6%), respectively. The only factor significantly associated with LR was FNCLCC grading, whereas histological subtype resulted associated with DM. At recurrence, 24 patients (57%) underwent surgery. Two-year post-relapse PFS and OS rates for patients developing LR or DM were 14.8, 41.0, 27.3, and 63.6%, respectively. CONCLUSIONS: LR after neoadjuvant CT-RT for RPS were predominantly infield. While almost one half of relapsed patients underwent further surgery, prognosis was poor.
Authors: Anthony M Villano; Roberto J Vidri; Elaine T Vo; Stephanie H Greco; Krisha J Howell; Margaret von Mehren; Jeffrey M Farma Journal: Ann Surg Oncol Date: 2021-10-11 Impact factor: 5.344
Authors: A Willner; K Fechner; A Agaimy; F Haller; M Eckstein; O J Ott; F Putz; U S Gaipl; S Kersting; N Meidenbauer; R Grützmann; R Fietkau; S Semrau Journal: Strahlenther Onkol Date: 2021-11-04 Impact factor: 3.621
Authors: Anna Maria Frezza; Alex T J Lee; Eran Nizri; Marta Sbaraglia; Robin L Jones; Alessandro Gronchi; Angelo Paolo Dei Tos; Paolo G Casali Journal: ESMO Open Date: 2018-06-28