INTRODUCTION: EORTC-62092 (STRASS) was a phase 3, randomized study that compared surgery alone versus surgery plus neoadjuvant radiotherapy (RT) for retroperitoneal sarcomas. RT was not associated with improved abdominal recurrence-free survival, the primary outcome measure, although on subanalysis, there may have been benefit for well-differentiated (WD) liposarcoma. This study investigated the real-world use and outcomes of RT (neoadjuvant and adjuvant) for the management of retroperitoneal liposarcoma. METHODS: We queried the National Cancer Database (NCDB) (2004-2017) for patients with nonmetastatic, primary retroperitoneal liposarcoma treated with resection with or without RT (n = 3911). Patients were stratified by treatment type and histology [WD (n = 2252), dedifferentiated (DD) (n = 1659)]. Propensity score (PS) matching was used before comparison of treatment groups. Overall survival (OS) was the primary outcome measure. RESULTS: Median follow-up time was 4.1 years, and median OS was 10.7 years. There was no association between RT and OS for either WDLPS or DDLPS cohorts. We performed a subgroup analysis of neoadjuvant RT only, similar to STRASS. For WDLPS after PS matching (n = 208), neoadjuvant RT was not associated with OS (hazard ratio [HR] 1.01, p = 0.0523) but was associated with longer postoperative hospital stay (p = 0.012). For DDLPS after PS matching (n = 290), neoadjuvant RT was not associated with OS (HR 1.02, p = 0.889). For both WD-LPS and DD-LPS, utilization of neoadjuvant RT was associated with treatment at high-volume (≥ 10 cases/year) and academic/network facilities. CONCLUSIONS: For primary retroperitoneal liposarcoma treated with surgical resection, radiotherapy was not associated with an overall survival benefit in this propensity-matched, adjusted analysis of the NCDB.
INTRODUCTION: EORTC-62092 (STRASS) was a phase 3, randomized study that compared surgery alone versus surgery plus neoadjuvant radiotherapy (RT) for retroperitoneal sarcomas. RT was not associated with improved abdominal recurrence-free survival, the primary outcome measure, although on subanalysis, there may have been benefit for well-differentiated (WD) liposarcoma. This study investigated the real-world use and outcomes of RT (neoadjuvant and adjuvant) for the management of retroperitoneal liposarcoma. METHODS: We queried the National Cancer Database (NCDB) (2004-2017) for patients with nonmetastatic, primary retroperitoneal liposarcoma treated with resection with or without RT (n = 3911). Patients were stratified by treatment type and histology [WD (n = 2252), dedifferentiated (DD) (n = 1659)]. Propensity score (PS) matching was used before comparison of treatment groups. Overall survival (OS) was the primary outcome measure. RESULTS: Median follow-up time was 4.1 years, and median OS was 10.7 years. There was no association between RT and OS for either WDLPS or DDLPS cohorts. We performed a subgroup analysis of neoadjuvant RT only, similar to STRASS. For WDLPS after PS matching (n = 208), neoadjuvant RT was not associated with OS (hazard ratio [HR] 1.01, p = 0.0523) but was associated with longer postoperative hospital stay (p = 0.012). For DDLPS after PS matching (n = 290), neoadjuvant RT was not associated with OS (HR 1.02, p = 0.889). For both WD-LPS and DD-LPS, utilization of neoadjuvant RT was associated with treatment at high-volume (≥ 10 cases/year) and academic/network facilities. CONCLUSIONS: For primary retroperitoneal liposarcoma treated with surgical resection, radiotherapy was not associated with an overall survival benefit in this propensity-matched, adjusted analysis of the NCDB.
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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: Kimberly Moore Dalal; Michael W Kattan; Cristina R Antonescu; Murray F Brennan; Samuel Singer Journal: Ann Surg Date: 2006-09 Impact factor: 12.969
Authors: Alessandro Gronchi; Rosalba Miceli; Elizabeth Shurell; Fritz C Eilber; Frederick R Eilber; Daniel A Anaya; Michael W Kattan; Charles Honoré; Dina C Lev; Chiara Colombo; Sylvie Bonvalot; Luigi Mariani; Raphael E Pollock Journal: J Clin Oncol Date: 2013-03-25 Impact factor: 44.544
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: J A Livingston; D Bugano; A Barbo; H Lin; J E Madewell; W L Wang; A J Lazar; W W Tseng; C L Roland; B W Feig; R Pollock; A P Conley; R S Benjamin; S Patel; N Somaiah Journal: Sci Rep Date: 2017-09-19 Impact factor: 4.379
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