Radiation Therapy for Retroperitoneal Sarcomas: Influences of Histology, Grade, and Size

Radiation Therapy for Retroperitoneal Sarcomas: Influences of Histology, Grade, and Size

Perioperative radiation therapy (RT) has been associated with reduced local recurrence in patients with retroperitoneal sarcomas (RPS); however, selection criteria remain unclear. We hypothesized that perioperative RT would improve survival in patients with RPS and would be associated with pathologi...

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Bibliographic Details
Published in:Sarcoma 2018, Vol.2018, p.7972389-8
Main Authors: Leiting, Jennifer L., Bergquist, John R., Hernandez, Matthew C., Merrell, Kenneth W., Folpe, Andrew L., Robinson, Steven I., Nagorney, David M., Truty, Mark J., Grotz, Travis E.
Format: Article
Language:eng
Subjects:
Antineoplastic agents
Cancer
Cancer recurrence
Cancer therapies
Care and treatment
Chemotherapy
Cohort analysis
Comorbidity
Epidemiology
Histochemistry
Histology
Medical prognosis
Medical research
Medicine, Experimental
Mortality
Oncology
Operating systems (Software)
Patients
Radiation (Physics)
Radiation therapy
Radiotherapy
Recurrence (Disease)
Relapse
Risk factors
Sarcoma
Statistical analysis
Stomach cancer
Surgery
Survival
Survival analysis
Tumors
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Summary:Perioperative radiation therapy (RT) has been associated with reduced local recurrence in patients with retroperitoneal sarcomas (RPS); however, selection criteria remain unclear. We hypothesized that perioperative RT would improve survival in patients with RPS and would be associated with pathological factors. The National Cancer Database (NCDB) from 2004 to 2012 was reviewed for patients with nonmetastatic RPS undergoing curative intent resection. Tumor size was dichotomized at 15 cm based on 8th edition American Joint Committee on Cancer (AJCC) staging. Patients with the highest comorbidity score were excluded. Unadjusted Kaplan–Meier and adjusted Cox proportional hazards modeling analyzed overall survival (OS). Multivariable logistic regression modeled margin positivity. A total of 2,264 patients were included; 727 patients (32.1%) had perioperative radiation in whom 203 (9.0%) had radiation preoperatively. Median (IQR) RPS size was 17.5 [11.0–27.0] cm. Histopathology was high grade in 1048 patients (43.7%). Multivariable analysis revealed that perioperative radiation was independently associated with decreased mortality (HR 0.72, 95% confidence intervals (CIs) 0.62–0.84, p
ISSN:1357-714X
1369-1643