Michael J Littau1, Sujay Kulshrestha2, Corinne Bunn2, Sonya Agnew3, Patrick Sweigert2, Fred A Luchette3, Marshall S Baker4. 1. Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA. 2. Department of Surgery, Loyola University Medical Center, Maywood, IL, USA. 3. Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA; Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; Edward Hines Jr., Veterans Administration Medical Center, Hines, IL, USA. 4. Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA; Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; Edward Hines Jr., Veterans Administration Medical Center, Hines, IL, USA. Electronic address: marshall.baker@lumc.edu.
Abstract
BACKGROUND: Prior studies evaluating the impact of adjuvant or neoadjuvant radiotherapy on clinical outcomes in retroperitoneal liposarcoma have been underpowered. METHODS: We queried the National Cancer Database for patients undergoing resection of retroperitoneal liposarcoma from 2004 to 2016. Cox proportional hazards modeling stratified by tumor size was used to identify factors associated with overall survival. RESULTS: 4018 patients met inclusion criteria. 251 had small (<5 cm), 574 intermediate (5-10 cm), and 3193 large (>10 cm) tumors. Positive surgical margins were correlated with risk of death across all tumor size categories (<5 cm HR 2.33, CI [1.20, 4.55]; 5-10 cm HR 1.49, CI [1.03, 2.14]; >10 cm HR 1.30, CI [1.12, 1.51]). Adjuvant radiotherapy was associated with improved survival for patients with large tumors only (HR 0.75, CI [0.64, 0.89]). CONCLUSIONS: In retroperitoneal liposarcoma, adjuvant radiation is associated with improved survival only for patients with tumors larger than 10 cm. Radiation should be used sparingly in patients with smaller tumors. SUMMARY: The use of radiotherapy in the management of retroperitoneal sarcoma remains controversial. We isolated retroperitoneal liposarcomas only and identified a survival benefit from radiotherapy treatment only in tumors larger than 10 cm and only in the adjuvant setting. Published by Elsevier Inc.
BACKGROUND: Prior studies evaluating the impact of adjuvant or neoadjuvant radiotherapy on clinical outcomes in retroperitoneal liposarcoma have been underpowered. METHODS: We queried the National Cancer Database for patients undergoing resection of retroperitoneal liposarcoma from 2004 to 2016. Cox proportional hazards modeling stratified by tumor size was used to identify factors associated with overall survival. RESULTS: 4018 patients met inclusion criteria. 251 had small (<5 cm), 574 intermediate (5-10 cm), and 3193 large (>10 cm) tumors. Positive surgical margins were correlated with risk of death across all tumor size categories (<5 cm HR 2.33, CI [1.20, 4.55]; 5-10 cm HR 1.49, CI [1.03, 2.14]; >10 cm HR 1.30, CI [1.12, 1.51]). Adjuvant radiotherapy was associated with improved survival for patients with large tumors only (HR 0.75, CI [0.64, 0.89]). CONCLUSIONS: In retroperitoneal liposarcoma, adjuvant radiation is associated with improved survival only for patients with tumors larger than 10 cm. Radiation should be used sparingly in patients with smaller tumors. SUMMARY: The use of radiotherapy in the management of retroperitoneal sarcoma remains controversial. We isolated retroperitoneal liposarcomas only and identified a survival benefit from radiotherapy treatment only in tumors larger than 10 cm and only in the adjuvant setting. Published by Elsevier Inc.
Authors: P G Casali; N Abecassis; H T Aro; S Bauer; R Biagini; S Bielack; S Bonvalot; I Boukovinas; J V M G Bovee; T Brodowicz; J M Broto; A Buonadonna; E De Álava; A P Dei Tos; X G Del Muro; P Dileo; M Eriksson; A Fedenko; V Ferraresi; A Ferrari; S Ferrari; A M Frezza; S Gasperoni; H Gelderblom; T Gil; G Grignani; A Gronchi; R L Haas; B Hassan; P Hohenberger; R Issels; H Joensuu; R L Jones; I Judson; P Jutte; S Kaal; B Kasper; K Kopeckova; D A Krákorová; A Le Cesne; I Lugowska; O Merimsky; M Montemurro; M A Pantaleo; R Piana; P Picci; S Piperno-Neumann; A L Pousa; P Reichardt; M H Robinson; P Rutkowski; A A Safwat; P Schöffski; S Sleijfer; S Stacchiotti; K Sundby Hall; M Unk; F Van Coevorden; W T A van der Graaf; J Whelan; E Wardelmann; O Zaikova; J Y Blay Journal: Ann Oncol Date: 2018-10-01 Impact factor: 32.976
Authors: Konstantinos Chouliaras; Rebecca Senehi; Cecilia G Ethun; George Poultsides; Valerie Grignol; Callisia N Clarke; Kevin K Roggin; Ryan C Fields; Patrick B Schwartz; Sean M Ronnekleiv-Kelly; Ralph D'Agostino; Emily N Johnson; Edward A Levine; Kenneth Cardona; Konstantinos I Votanopoulos Journal: J Surg Oncol Date: 2019-09-04 Impact factor: 3.454
Authors: Sylvie Bonvalot; Alessandro Gronchi; Cécile Le Péchoux; Carol J Swallow; Dirk Strauss; Pierre Meeus; Frits van Coevorden; Stephan Stoldt; Eberhard Stoeckle; Piotr Rutkowski; Marco Rastrelli; Chandrajit P Raut; Daphne Hompes; Antonino De Paoli; Claudia Sangalli; Charles Honoré; Peter Chung; Aisha Miah; Jean Yves Blay; Marco Fiore; Jean-Jacques Stelmes; Angelo P Dei Tos; Elizabeth H Baldini; Saskia Litière; Sandrine Marreaud; Hans Gelderblom; Rick L Haas Journal: Lancet Oncol Date: 2020-09-14 Impact factor: 41.316
Authors: Linn H Trovik; Kjell Ovrebo; Martin Almquist; Hans Kristian Haugland; Pehr Rissler; Johan Eide; Jacob Engellau; Odd R Monge; Anniken B Nyhus; Ingvild K Elde; Nina L Jebsen Journal: Acta Oncol Date: 2014-07-07 Impact factor: 4.089
Authors: Whitney O Lane; Christina K Cramer; Daniel P Nussbaum; Paul J Speicher; Brian C Gulack; Brian G Czito; David G Kirsch; Douglas S Tyler; Dan G Blazer Journal: J Surg Oncol Date: 2015-08-04 Impact factor: 3.454
Authors: Daniel P Nussbaum; Christel N Rushing; Whitney O Lane; Diana M Cardona; David G Kirsch; Bercedis L Peterson; Dan G Blazer Journal: Lancet Oncol Date: 2016-05-17 Impact factor: 41.316
Authors: Jennifer L Leiting; John R Bergquist; Matthew C Hernandez; Kenneth W Merrell; Andrew L Folpe; Steven I Robinson; David M Nagorney; Mark J Truty; Travis E Grotz Journal: Sarcoma Date: 2018-12-05
Authors: Rick L M Haas; Sylvie Bonvalot; Rosalba Miceli; Dirk C Strauss; Carol J Swallow; Peter Hohenberger; Frits van Coevorden; Piotr Rutkowski; Dario Callegaro; Andrew J Hayes; Charles Honoré; Mark Fairweather; Rebecca Gladdy; Jens Jakob; Milena Szacht; Marco Fiore; Peter W Chung; Winan J van Houdt; Chandrajit P Raut; Alessandro Gronchi Journal: Cancer Date: 2019-01-02 Impact factor: 6.860