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Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis

BACKGROUND: Adjuvant therapy is a promising treatment to improve the prognosis of cancer patients, however, the evidence base driving recommendations for adjuvant radiotherapy (ART) or chemotherapy (ACT) in retroperitoneal sarcomas (RPS) primarily hinges on observational data. The aim of this study...

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Autores principales: Li, Xiangji, Wu, Tong, Xiao, Mengmeng, Wu, Shanshan, Min, Li, Luo, Chenghua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496039/
https://www.ncbi.nlm.nih.gov/pubmed/34620197
http://dx.doi.org/10.1186/s13014-021-01774-w
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author Li, Xiangji
Wu, Tong
Xiao, Mengmeng
Wu, Shanshan
Min, Li
Luo, Chenghua
author_facet Li, Xiangji
Wu, Tong
Xiao, Mengmeng
Wu, Shanshan
Min, Li
Luo, Chenghua
author_sort Li, Xiangji
collection PubMed
description BACKGROUND: Adjuvant therapy is a promising treatment to improve the prognosis of cancer patients, however, the evidence base driving recommendations for adjuvant radiotherapy (ART) or chemotherapy (ACT) in retroperitoneal sarcomas (RPS) primarily hinges on observational data. The aim of this study was to evaluate the effectiveness of adjuvant therapy in the management of RPS patients. METHODS: We searched PubMed, Web of Science, Embase, ASCO Abstracts, and Cochrane Library for comparative studies (until December 2020) of adjuvant therapy versus surgery alone. Data on the following endpoints were evaluated: overall survival (OS), local recurrence (LR), recurrence-free survival (RFS), and metastasis-free survival (MFS). Data were summarized as hazard ratios (HR) with 95% confidence intervals (CI). Risk of bias of studies was assessed with Begg’s and Egger’s tests. RESULTS: A total of 15 trials were eligible, including 9281 adjuvant therapy and 21,583 surgery alone cases (20 studies for OS, six studies for RFS, two studies for LR, and two studies for MFS). Meta-analysis showed that ART was associated with distinct advantages as compared to surgery alone, including a longer OS (HR = 0.80, P < 0.0001), a longer RFS (HR = 0.61, P = 0.0002), and a lower LR (HR = 0.31, P = 0.005). However, this meta-analysis failed to demonstrate a benefit of ACT for RPS patients, including OS (HR = 1.11, P = 0.19), RFS (HR = 1.30, P = 0.09) and MFS (HR = 0.69, P = 0.09). In the sensitivity analysis, ACT was associated with a worse OS (HR = 1.19, P = 0.0002). No evidence of publication bias was observed. CONCLUSIONS: Overall, the quality of the evidence was moderate for most outcomes. The evidence supports that ART achieved a generally better outcome as compared to surgery alone. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13014-021-01774-w.
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spelling pubmed-84960392021-10-07 Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis Li, Xiangji Wu, Tong Xiao, Mengmeng Wu, Shanshan Min, Li Luo, Chenghua Radiat Oncol Research BACKGROUND: Adjuvant therapy is a promising treatment to improve the prognosis of cancer patients, however, the evidence base driving recommendations for adjuvant radiotherapy (ART) or chemotherapy (ACT) in retroperitoneal sarcomas (RPS) primarily hinges on observational data. The aim of this study was to evaluate the effectiveness of adjuvant therapy in the management of RPS patients. METHODS: We searched PubMed, Web of Science, Embase, ASCO Abstracts, and Cochrane Library for comparative studies (until December 2020) of adjuvant therapy versus surgery alone. Data on the following endpoints were evaluated: overall survival (OS), local recurrence (LR), recurrence-free survival (RFS), and metastasis-free survival (MFS). Data were summarized as hazard ratios (HR) with 95% confidence intervals (CI). Risk of bias of studies was assessed with Begg’s and Egger’s tests. RESULTS: A total of 15 trials were eligible, including 9281 adjuvant therapy and 21,583 surgery alone cases (20 studies for OS, six studies for RFS, two studies for LR, and two studies for MFS). Meta-analysis showed that ART was associated with distinct advantages as compared to surgery alone, including a longer OS (HR = 0.80, P < 0.0001), a longer RFS (HR = 0.61, P = 0.0002), and a lower LR (HR = 0.31, P = 0.005). However, this meta-analysis failed to demonstrate a benefit of ACT for RPS patients, including OS (HR = 1.11, P = 0.19), RFS (HR = 1.30, P = 0.09) and MFS (HR = 0.69, P = 0.09). In the sensitivity analysis, ACT was associated with a worse OS (HR = 1.19, P = 0.0002). No evidence of publication bias was observed. CONCLUSIONS: Overall, the quality of the evidence was moderate for most outcomes. The evidence supports that ART achieved a generally better outcome as compared to surgery alone. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13014-021-01774-w. BioMed Central 2021-10-07 /pmc/articles/PMC8496039/ /pubmed/34620197 http://dx.doi.org/10.1186/s13014-021-01774-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Li, Xiangji
Wu, Tong
Xiao, Mengmeng
Wu, Shanshan
Min, Li
Luo, Chenghua
Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis
title Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis
title_full Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis
title_fullStr Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis
title_full_unstemmed Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis
title_short Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis
title_sort adjuvant therapy for retroperitoneal sarcoma: a meta-analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496039/
https://www.ncbi.nlm.nih.gov/pubmed/34620197
http://dx.doi.org/10.1186/s13014-021-01774-w
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