Long-term results of two prospective trials of preoperative external beam radiotherapy for localized intermediate- or high-grade retroperitoneal soft tissue sarcoma

Timothy M. Pawlik, Peter W T Pisters, Lynn Mikula, Barry W. Feig, Kelly K. Hunt, Janice N. Cormier, Matthew T. Ballo, Charles N. Catton, Julia J. Jones, Brian O'Sullivan, Raphael E. Pollock, Carol J. Swallow

Research output: Contribution to journalArticle

Abstract

Background: The reported data on surgery plus radiotherapy for retroperitoneal soft tissue sarcomas (RPS) have been mostly from retrospective studies. We evaluated the long-term outcome of patients with operable RPS who were treated with protocol-based preoperative radiotherapy followed by complete surgical resection. Methods: Data from two prospective trials that included preoperative radiotherapy and surgery for patients with radiographically resectable RPS were combined to define long-term relapse rates and survival. Results: Seventy-two patients with intermediate- or high-grade RPS were treated with preoperative radiotherapy (median dose, 45 Gy; range, 18.0-50.4 Gy). Fifty-four patients (75%) had primary RPS, whereas 18 (25%) had recurrent disease. The median tumor size was 15.5 cm. Sixty-four patients completed the planned preoperative radiotherapy; 57 (89%) underwent laparotomy with curative intent, and 54 (95%) had a macroscopically complete (R0 or R1) resection. With a median follow-up of 40.3 months, 28 patients (52%) who received preoperative radiotherapy and underwent a macroscopically complete resection had recurrences. For the 54 patients who underwent R0 or R1 resection after preoperative radiotherapy, the 5-year local recurrence-free, disease-free, and overall survival rates were 60%, 46%, and 61%, respectively. The median overall survival has not been reached (>60 months). Conclusions: Patients with intermediate- or high-grade RPS treated with preoperative radiotherapy plus complete resection had a median survival >60 months. This compares favorably to historical data for similar patients treated with surgery alone.

Original languageEnglish (US)
Pages (from-to)508-517
Number of pages10
JournalAnnals of Surgical Oncology
Volume13
Issue number4
DOIs
StatePublished - Apr 2006
Externally publishedYes

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Sarcoma
Radiotherapy
Recurrence
Survival Rate
Survival
Laparotomy
Disease-Free Survival
Retrospective Studies

Keywords

  • Preoperative
  • Radiation
  • Recurrence
  • Resection
  • Retroperitoneal sarcoma
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Long-term results of two prospective trials of preoperative external beam radiotherapy for localized intermediate- or high-grade retroperitoneal soft tissue sarcoma. / Pawlik, Timothy M.; Pisters, Peter W T; Mikula, Lynn; Feig, Barry W.; Hunt, Kelly K.; Cormier, Janice N.; Ballo, Matthew T.; Catton, Charles N.; Jones, Julia J.; O'Sullivan, Brian; Pollock, Raphael E.; Swallow, Carol J.

In: Annals of Surgical Oncology, Vol. 13, No. 4, 04.2006, p. 508-517.

Research output: Contribution to journalArticle

Pawlik, TM, Pisters, PWT, Mikula, L, Feig, BW, Hunt, KK, Cormier, JN, Ballo, MT, Catton, CN, Jones, JJ, O'Sullivan, B, Pollock, RE & Swallow, CJ 2006, 'Long-term results of two prospective trials of preoperative external beam radiotherapy for localized intermediate- or high-grade retroperitoneal soft tissue sarcoma', Annals of Surgical Oncology, vol. 13, no. 4, pp. 508-517. https://doi.org/10.1245/ASO.2006.05.035
Pawlik, Timothy M. ; Pisters, Peter W T ; Mikula, Lynn ; Feig, Barry W. ; Hunt, Kelly K. ; Cormier, Janice N. ; Ballo, Matthew T. ; Catton, Charles N. ; Jones, Julia J. ; O'Sullivan, Brian ; Pollock, Raphael E. ; Swallow, Carol J. / Long-term results of two prospective trials of preoperative external beam radiotherapy for localized intermediate- or high-grade retroperitoneal soft tissue sarcoma. In: Annals of Surgical Oncology. 2006 ; Vol. 13, No. 4. pp. 508-517.
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abstract = "Background: The reported data on surgery plus radiotherapy for retroperitoneal soft tissue sarcomas (RPS) have been mostly from retrospective studies. We evaluated the long-term outcome of patients with operable RPS who were treated with protocol-based preoperative radiotherapy followed by complete surgical resection. Methods: Data from two prospective trials that included preoperative radiotherapy and surgery for patients with radiographically resectable RPS were combined to define long-term relapse rates and survival. Results: Seventy-two patients with intermediate- or high-grade RPS were treated with preoperative radiotherapy (median dose, 45 Gy; range, 18.0-50.4 Gy). Fifty-four patients (75{\%}) had primary RPS, whereas 18 (25{\%}) had recurrent disease. The median tumor size was 15.5 cm. Sixty-four patients completed the planned preoperative radiotherapy; 57 (89{\%}) underwent laparotomy with curative intent, and 54 (95{\%}) had a macroscopically complete (R0 or R1) resection. With a median follow-up of 40.3 months, 28 patients (52{\%}) who received preoperative radiotherapy and underwent a macroscopically complete resection had recurrences. For the 54 patients who underwent R0 or R1 resection after preoperative radiotherapy, the 5-year local recurrence-free, disease-free, and overall survival rates were 60{\%}, 46{\%}, and 61{\%}, respectively. The median overall survival has not been reached (>60 months). Conclusions: Patients with intermediate- or high-grade RPS treated with preoperative radiotherapy plus complete resection had a median survival >60 months. This compares favorably to historical data for similar patients treated with surgery alone.",
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T1 - Long-term results of two prospective trials of preoperative external beam radiotherapy for localized intermediate- or high-grade retroperitoneal soft tissue sarcoma

AU - Pawlik, Timothy M.

AU - Pisters, Peter W T

AU - Mikula, Lynn

AU - Feig, Barry W.

AU - Hunt, Kelly K.

AU - Cormier, Janice N.

AU - Ballo, Matthew T.

AU - Catton, Charles N.

AU - Jones, Julia J.

AU - O'Sullivan, Brian

AU - Pollock, Raphael E.

AU - Swallow, Carol J.

PY - 2006/4

Y1 - 2006/4

N2 - Background: The reported data on surgery plus radiotherapy for retroperitoneal soft tissue sarcomas (RPS) have been mostly from retrospective studies. We evaluated the long-term outcome of patients with operable RPS who were treated with protocol-based preoperative radiotherapy followed by complete surgical resection. Methods: Data from two prospective trials that included preoperative radiotherapy and surgery for patients with radiographically resectable RPS were combined to define long-term relapse rates and survival. Results: Seventy-two patients with intermediate- or high-grade RPS were treated with preoperative radiotherapy (median dose, 45 Gy; range, 18.0-50.4 Gy). Fifty-four patients (75%) had primary RPS, whereas 18 (25%) had recurrent disease. The median tumor size was 15.5 cm. Sixty-four patients completed the planned preoperative radiotherapy; 57 (89%) underwent laparotomy with curative intent, and 54 (95%) had a macroscopically complete (R0 or R1) resection. With a median follow-up of 40.3 months, 28 patients (52%) who received preoperative radiotherapy and underwent a macroscopically complete resection had recurrences. For the 54 patients who underwent R0 or R1 resection after preoperative radiotherapy, the 5-year local recurrence-free, disease-free, and overall survival rates were 60%, 46%, and 61%, respectively. The median overall survival has not been reached (>60 months). Conclusions: Patients with intermediate- or high-grade RPS treated with preoperative radiotherapy plus complete resection had a median survival >60 months. This compares favorably to historical data for similar patients treated with surgery alone.

AB - Background: The reported data on surgery plus radiotherapy for retroperitoneal soft tissue sarcomas (RPS) have been mostly from retrospective studies. We evaluated the long-term outcome of patients with operable RPS who were treated with protocol-based preoperative radiotherapy followed by complete surgical resection. Methods: Data from two prospective trials that included preoperative radiotherapy and surgery for patients with radiographically resectable RPS were combined to define long-term relapse rates and survival. Results: Seventy-two patients with intermediate- or high-grade RPS were treated with preoperative radiotherapy (median dose, 45 Gy; range, 18.0-50.4 Gy). Fifty-four patients (75%) had primary RPS, whereas 18 (25%) had recurrent disease. The median tumor size was 15.5 cm. Sixty-four patients completed the planned preoperative radiotherapy; 57 (89%) underwent laparotomy with curative intent, and 54 (95%) had a macroscopically complete (R0 or R1) resection. With a median follow-up of 40.3 months, 28 patients (52%) who received preoperative radiotherapy and underwent a macroscopically complete resection had recurrences. For the 54 patients who underwent R0 or R1 resection after preoperative radiotherapy, the 5-year local recurrence-free, disease-free, and overall survival rates were 60%, 46%, and 61%, respectively. The median overall survival has not been reached (>60 months). Conclusions: Patients with intermediate- or high-grade RPS treated with preoperative radiotherapy plus complete resection had a median survival >60 months. This compares favorably to historical data for similar patients treated with surgery alone.

KW - Preoperative

KW - Radiation

KW - Recurrence

KW - Resection

KW - Retroperitoneal sarcoma

KW - Survival

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