Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity.

Yang, James Chih‐Hsin; Chang, Alfred E.; Baker, Andrew T.; Sindelar, William F.; Danforth, David N.; Topalian, Suzanne L.; DeLaney, Thomas F.; Glatstein, Eli; Steinberg, Seth M.; Merino, María J.; Rosenberg, Steven A.

doi:10.1200/jco.1998.16.1.197

Cited by 1,379 publications

(861 citation statements)

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“…Radiation therapy has been shown to significantly decrease local relapse following surgery for both extremity and retroperitoneal sarcomas, and by extrapolation, would be expected to decrease local relapse in patients with pelvic sarcomas if adequate dose can be safely delivered. 16,17 Similar findings using chemotherapy alone, or in combination with radiation, have been seen for extremity and retroperitoneal soft tissue sarcomas, resulting in decreased local and distant relapse with trends toward improved survival. 15,18,19 With the small numbers in our series, meaningful conclusions as to the utility of adjuvant therapy in this surgical setting cannot be drawn.…”

Section: Discussionsupporting

confidence: 52%

Surgical Approach and Oncologic Outcomes Following Multidisciplinary Management of Retrorectal Sarcomas

Dozois

Jacofsky

Billings

et al. 2011

Indian J Surg Oncol

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Background. Retrorectal sarcomas are rare, and limited data are available on oncologic outcomes following surgery. Our aim was to evaluate outcomes in this patient population at our institution. Materials and Methods. All patients who underwent surgical resection of a malignant retrorectal/presacral sarcoma between 1985 and 2005 were identified. Data analyzed included demographics, histopathologic diagnosis, surgical morbidity and mortality, use of adjuvant therapy, local and distant recurrence, and survival. Results. A total of 37 patients were identified (20 males) with a median age of 49 years (range, 22-81 years). The most common histopathologic diagnosis was malignant peripheral nerve sheath tumor (n = 8). Also, 22 tumors were high grade and 15 were low grade. Surgical margin status was R0 in 31 patients and R1 in 6. Adjuvant therapy was given to 26 patients. Postoperative morbidity and mortality was 57% and 3%, respectively. Median length of follow-up in 16 patients alive at last contact was 4.7 years. The 5-year survival free of local (LDFS), distant (DDFS), and local or distant recurrence (DFS) was 51, 58, and 39%, respectively. Patient survival at 2, 5, and 10 years was 75, 55, and 47%, respectively. Disease-free survival was not significantly associated with gender (P = .16), primary vs secondary (P = .94), R0 vs R1 resection (P = .26), low vs high tumor grade (P = .17), or the use of surgery with or without adjuvant therapy (P = .33).

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Section: Discussionsupporting

confidence: 52%

Surgical Approach and Oncologic Outcomes Following Multidisciplinary Management of Retrorectal Sarcomas

Dozois

Jacofsky

Billings

et al. 2011

Indian J Surg Oncol

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“…Although the effectiveness of radiation therapy has been demonstrated for patients with soft-tissue sarcomas of the limb [20], its effectiveness is limited in patients with RPS by the difficulty in delivering adequate doses to the retroperitoneum and the abdomen [17]. There are ongoing trials of preoperative radiation associated with an intraoperative or a postoperative boost [21,22].…”

Section: Discussionmentioning

confidence: 99%

Challenges in the Surgical Treatment of Retroperitoneal Sarcomas

et al. 2015

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The objective of this study is to assess long-term prognosis and patterns of failure in patients with retroperitoneal sarcoma who underwent surgery with curative intent at a single institution. We also provide a thorough review of the literature including several series and widely variable data regarding local and distant failure. During a 25-year period , 45 consecutive patients who underwent surgery for retroperitoneal sarcoma at a single referral center were reviewed retrospectively. We recorded and analyzed the presenting symptoms, type of surgical excision, and the 5-year survival rate as well as the local recurrence rate of patients with complete tumor resection. Overall survival is significantly diminished in patients in whom resection margins are not adequate. In our series, 5-year recurrence rate for patients with complete and incomplete resection of the tumor was 30.76 and 68.42 %, respectively. The 5-year survival rate was 51.12 %, and the 5-year survival rate according to type of resection was 76.93 % for complete and 15.79 % for incomplete resections. Local recurrence after first surgery and high-grade malignancy are associated with poor survival. The role of radiation therapy and chemotherapy in the treatment of retroperitoneal sarcoma (RPS) should be investigated further. Complete en bloc resection of the tumor mass and adjacent structures is the single most important factor that improves survival.

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“…However, although the procedure easily may miss its objective in the former group, it may be crucial in the latter group. Unfortunately, the role of radiation therapy, the adjuvant effectiveness of which has been demonstrated for patients with STS of the limb, 21,27 is limited by the difficulty in delivering adequate doses to the retroperitoneum and the abdomen. In this regard, there are ongoing trials of preoperative radiation associated with a perioperative (intraoperative or postoperative) boost.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the approach to retroperitoneal STS is under active investigation. Novel radiation therapy techniques have been explored, [11][12][13][14][15][16][17][18][19][20][21] and the role of adjuvant chemotherapy still is debated. 22,23 However, efforts to improve treatment results should be based on the patterns in which these tumors currently fail.…”

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confidence: 99%

Retroperitoneal soft tissue sarcomas

Gronchi

Casali

Fiore

et al. 2004

Cancer

159

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BACKGROUNDThe objective of this study was to assess long‐term prognosis and patterns of failure in patients with retroperitoneal soft tissue sarcoma who underwent surgery with curative intent at a single institution. Several series of patients with retroperitoneal sarcoma were reported, providing widely variable data regarding local and distant failure.METHODSOverall, 167 consecutive patients who underwent surgery for retroperitoneal soft tissue sarcoma over a 20 year span at a single referral center were reviewed retrospectively. Eighty‐two patients presented with primary disease, whereas 85 patients had recurrent locoregional tumors. Surgical resection was considered macroscopically complete in 147 of 167 patients (88%).RESULTSOverall survival at 10 years after definitive surgery was approximately 27%, and the disease‐free survival was approximately 16%. Only a minority of patients developed distant metastases. The risk of recurrence was correlated with whether patients underwent surgery for primary disease or for recurrent disease; the 10 year disease‐free survival rate was 27% in the former group and 4.6% in the latter group. Histotype and malignancy grade were other prognostic factors, with the former found to be predictive of the pattern of failure and the latter predictive of overall survival.CONCLUSIONSLocal recurrence after primary surgery and high‐grade malignancy were associated with the worst survival. Histologic subtype appeared to influence the pattern of recurrence, which mainly was local for patients with liposarcoma but was both local and distant for patients with the other histotypes. Cancer 2004. © 2004 American Cancer Society.

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Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity.

Abstract: This study indicates that although postoperative external-beam radiotherapy is highly effective in preventing LRs, selected patients with extremity soft tissue sarcoma who have a low risk of LR may not require adjuvant XRT after limb-sparing surgery (LSS).

Cited by 1,379 publications

References 25 publications

Surgical Approach and Oncologic Outcomes Following Multidisciplinary Management of Retrorectal Sarcomas

Surgical Approach and Oncologic Outcomes Following Multidisciplinary Management of Retrorectal Sarcomas

Challenges in the Surgical Treatment of Retroperitoneal Sarcomas

Retroperitoneal soft tissue sarcomas

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