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Radiotherapy for retroperitoneal liposarcoma: A report from the Transatlantic Retroperitoneal Sarcoma Working Group.
Haas, Rick L M; Bonvalot, Sylvie; Miceli, Rosalba; Strauss, Dirk C; Swallow, Carol J; Hohenberger, Peter; van Coevorden, Frits; Rutkowski, Piotr; Callegaro, Dario; Hayes, Andrew J; Honoré, Charles; Fairweather, Mark; Gladdy, Rebecca; Jakob, Jens; Szacht, Milena; Fiore, Marco; Chung, Peter W; van Houdt, Winan J; Raut, Chandrajit P; Gronchi, Alessandro.
Afiliación
  • Haas RLM; Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
  • Bonvalot S; Department of Radiation Oncology, Leiden University Medical Centre, Leiden, The Netherlands.
  • Miceli R; Department of Surgery, Institute Curie, Paris, France.
  • Strauss DC; Unit of Clinical Epidemiology and Trial Organization, IRCCS Foundation National Cancer Institute, Milan, Italy.
  • Swallow CJ; Department of Surgery, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
  • Hohenberger P; Department of Surgical Oncology, Mount Sinai Hospital and Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
  • van Coevorden F; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
  • Rutkowski P; Division of Surgical Oncology and Thoracic Surgery, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany.
  • Callegaro D; Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
  • Hayes AJ; Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland.
  • Honoré C; Department of Surgery, IRCCS Foundation National Cancer Institute, Milan, Italy.
  • Fairweather M; Department of Surgery, Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
  • Gladdy R; Department of Surgery, Institute Gustave Roussy, Villejuif, France.
  • Jakob J; Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
  • Szacht M; Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
  • Fiore M; Department of Surgical Oncology, Mount Sinai Hospital and Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
  • Chung PW; Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
  • van Houdt WJ; Division of Surgical Oncology and Thoracic Surgery, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany.
  • Raut CP; Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland.
  • Gronchi A; Department of Surgery, IRCCS Foundation National Cancer Institute, Milan, Italy.
Cancer ; 125(8): 1290-1300, 2019 04 15.
Article en En | MEDLINE | ID: mdl-30602058
BACKGROUND: The current study investigated the role of radiotherapy (RT) in patients with primary nonmetastatic retroperitoneal liposarcomas. METHODS: A total of 607 patients with localized retroperitoneal well-differentiated liposarcomas (WDLPS) and dedifferentiated liposarcomas (DDLPS) underwent surgical resection with or without RT at 8 high-volume sarcoma centers (234 patients with WDLPS, 242 patients with grade 1 to 2 DDLPS, and 131 patients with grade 3 DDLPS; grading was performed according to the National Federation of Centers for the Fight Against Cancer [Federation Nationale des Centres de Lutte Contre le Cancer; FNCLCC]). RT was administered in 19.7%, 34.7%, and 35.1%, respectively, of these 3 cohorts. Overall survival (OS) was estimated using the Kaplan-Meier method, and the incidences of local recurrence and distant metastasis (DM) were estimated in a competing risk framework. To account for bias consistent with nonrandom RT assignment, propensity scores were estimated. Cox univariable analysis of the association between RT and oncological endpoints was performed by applying inverse probability of treatment weighting (IPTW) using propensity scores. RESULTS: Age, tumor size, and the administration of chemotherapy were found to be significantly imbalanced between patients who did and did not undergo RT in all cohorts. IPTW largely removed imbalances in key prognostic variables. Although the 8-year local recurrence incidences in patients treated with surgery plus RT versus surgery only were 11.8% and 39.2%, respectively, for patients with WDLPS (P = .011;); 29.0% and 56.7%, respectively, for patients with grade 1 to 2 DDLPS (P = .008); and 29.8% and 43.7%, respectively, for patients with grade 3 DDLPS (P = .025), this significant benefit was lost after IPTW analyses. There were no significant differences noted with regard to DM and OS between irradiated and unirradiated patients across all 3 cohorts. CONCLUSIONS: Perioperative RT was found to be associated with better local control in univariable unadjusted analysis in all 3 cohorts, but not after accounting for imbalances in prognostic variables. RT did not impact on DM or OS. The appropriate selection of RT in this disease remains challenging. The results of the European Organization for Research and Treatment of Cancer (EORTC)-Soft Tissue and Bone Sarcoma Group (STBSG) 62092-22092 prospective randomized trial are awaited.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Retroperitoneales / Liposarcoma Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cancer Año: 2019 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Retroperitoneales / Liposarcoma Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cancer Año: 2019 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos