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Radiotherapy for retroperitoneal liposarcoma: A report from the Transatlantic Retroperitoneal Sarcoma Working Group
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 s...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590287/ https://www.ncbi.nlm.nih.gov/pubmed/30602058 http://dx.doi.org/10.1002/cncr.31927 |
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author | 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 |
author_facet | 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 |
author_sort | Haas, Rick L. M. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6590287 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-65902872019-07-08 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 Cancer Original Articles 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. John Wiley and Sons Inc. 2019-01-02 2019-04-15 /pmc/articles/PMC6590287/ /pubmed/30602058 http://dx.doi.org/10.1002/cncr.31927 Text en © 2019 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles 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 Radiotherapy for retroperitoneal liposarcoma: A report from the Transatlantic Retroperitoneal Sarcoma Working Group |
title | Radiotherapy for retroperitoneal liposarcoma: A report from the Transatlantic Retroperitoneal Sarcoma Working Group |
title_full | Radiotherapy for retroperitoneal liposarcoma: A report from the Transatlantic Retroperitoneal Sarcoma Working Group |
title_fullStr | Radiotherapy for retroperitoneal liposarcoma: A report from the Transatlantic Retroperitoneal Sarcoma Working Group |
title_full_unstemmed | Radiotherapy for retroperitoneal liposarcoma: A report from the Transatlantic Retroperitoneal Sarcoma Working Group |
title_short | Radiotherapy for retroperitoneal liposarcoma: A report from the Transatlantic Retroperitoneal Sarcoma Working Group |
title_sort | radiotherapy for retroperitoneal liposarcoma: a report from the transatlantic retroperitoneal sarcoma working group |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590287/ https://www.ncbi.nlm.nih.gov/pubmed/30602058 http://dx.doi.org/10.1002/cncr.31927 |
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