The importance of the margin of resection and radiotherapy in retroperitoneal liposarcoma

Prior studies evaluating the impact of adjuvant or neoadjuvant radiotherapy on clinical outcomes in retroperitoneal liposarcoma have been underpowered. We queried the National Cancer Database for patients undergoing resection of retroperitoneal liposarcoma from 2004 to 2016. Cox proportional hazards...

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Bibliographic Details
Published in:The American journal of surgery 2021-03, Vol.221 (3), p.554-560
Main Authors: Littau, Michael J., Kulshrestha, Sujay, Bunn, Corinne, Agnew, Sonya, Sweigert, Patrick, Luchette, Fred A., Baker, Marshall S.
Format: Article
Language:English
Subjects:
Age
Aged
Cancer therapies
Comorbidity
Databases, Factual
Disease
Female
Gastric cancer
Hazard identification
Histology
Humans
Liposarcoma
Liposarcoma - mortality
Liposarcoma - radiotherapy
Liposarcoma - surgery
Male
Margins of Excision
Middle Aged
Neoadjuvant Therapy
Patients
Proportional Hazards Models
Radiation
Radiation therapy
Radiotherapy
Radiotherapy, Adjuvant
Retroperitoneal Neoplasms - mortality
Retroperitoneal Neoplasms - radiotherapy
Retroperitoneal Neoplasms - surgery
Retroperitoneal sarcoma
Retrospective Studies
Sarcoma
Surgery
Survival
Survival Rate
Treatment Outcome
Tumors
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Summary:Prior studies evaluating the impact of adjuvant or neoadjuvant radiotherapy on clinical outcomes in retroperitoneal liposarcoma have been underpowered. 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. 4018 patients met inclusion criteria. 251 had small (10 cm) tumors. Positive surgical margins were correlated with risk of death across all tumor size categories (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]). 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. 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. •No survival benefit from radiotherapy for retroperitoneal liposarcoma
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2020.11.041