Predicting survival in patients undergoing resection for locally recurrent retroperitoneal sarcoma

A study and novel nomogram from TARPSWG

Chandrajit P. Raut, Dario Callegaro, Rosalba Miceli, Francesco Barretta, Piotr Rutkowski, Jean Yves Blay, Guy Lahat, Dirk C. Strauss, Ricardo Gonzalez, Nita Ahuja, Giovanni Grignani, Vittorio Quagliuolo, Eberhard Stoeckle, Antonino De Paoli, Venu G. Pillarisetty, Carolyn Nessim, Carol J. Swallow, Sanjay Bagaria, Robert Canter, John Mullen & 7 others Hans J. Gelderblom, Elisabetta Pennacchioli, Frits Van Coevorden, Kenneth Cardona, Marco Fiore, Mark Fairweather, Alessandro Gronchi

Research output: Contribution to journalArticle

Abstract

Purpose: The role of surgery for first relapse locally recurrent retroperitoneal sarcoma (RPS-LR1) is uncertain. We report outcomes of the largest RPS-LR1 series and propose a new prognostic nomogram. Experimental Design: Patients with consecutive RPS-LR1 without distant metastases who underwent resection at 22 centers (2002-2011) were included. Endpoints were diseasefree and overall survival (DFS, OS) and crude-cumulativeincidence (CCI) of local/distant recurrence from second surgery. Nomograms predicting DFS and OS from second surgery were developed and validated (calibration plots); discrimination was assessed (Harrell C index). Results: Of 684 patients identified, full prognostic variable data were available for 602. Initial surgery for primary RPS was performed at our institutions in 188 patients (31%) and elsewhere in 414 (69%). At a median follow-up of 119 months [Interquartile range (IQR), 80-169] from initial surgery and 75 months (IQR 50-105) from second surgery, 6-year DFS and OS were 19.2% [95% confidence interval (CI), 16.0-23.0%] and 54.1% (95% CI, 49.8-58.8%), respectively. Recurrence patterns and survival probability were histology-specific, with liposarcoma subtypes having the highest 6-year CCI of second local recurrence (LR, 60.2%-70.9%) and leiomyosarcoma (LMS) having higher 6-year CCI of distant metastasis (DM, 36.3%). Nomograms included age at second surgery, multifocality, grade, completeness of second surgery, histology, chemotherapy/radiotherapy at first surgery, and number of organs resected at first surgery. OS and DFS nomograms showed good calibration and discriminative ability (C index 0.70 and 0.67, respectively). Conclusions: We developed nomograms to predict DFS and OS for patients undergoing RPS-LR1 resection. Nomograms provide individualized, disease-relevant estimations of survival for RPS-LR1 patients and assist in clinical decisions.

Original languageEnglish (US)
Pages (from-to)2664-2671
Number of pages8
JournalClinical Cancer Research
Volume25
Issue number8
DOIs
StatePublished - Apr 15 2019

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Nomograms
Sarcoma
Survival
Recurrence
Calibration
Histology
Confidence Intervals
Neoplasm Metastasis
Liposarcoma
Leiomyosarcoma
Research Design
Radiotherapy
Drug Therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Predicting survival in patients undergoing resection for locally recurrent retroperitoneal sarcoma : A study and novel nomogram from TARPSWG. / Raut, Chandrajit P.; Callegaro, Dario; Miceli, Rosalba; Barretta, Francesco; Rutkowski, Piotr; Blay, Jean Yves; Lahat, Guy; Strauss, Dirk C.; Gonzalez, Ricardo; Ahuja, Nita; Grignani, Giovanni; Quagliuolo, Vittorio; Stoeckle, Eberhard; De Paoli, Antonino; Pillarisetty, Venu G.; Nessim, Carolyn; Swallow, Carol J.; Bagaria, Sanjay; Canter, Robert; Mullen, John; Gelderblom, Hans J.; Pennacchioli, Elisabetta; Van Coevorden, Frits; Cardona, Kenneth; Fiore, Marco; Fairweather, Mark; Gronchi, Alessandro.

In: Clinical Cancer Research, Vol. 25, No. 8, 15.04.2019, p. 2664-2671.

Research output: Contribution to journalArticle

Raut, CP, Callegaro, D, Miceli, R, Barretta, F, Rutkowski, P, Blay, JY, Lahat, G, Strauss, DC, Gonzalez, R, Ahuja, N, Grignani, G, Quagliuolo, V, Stoeckle, E, De Paoli, A, Pillarisetty, VG, Nessim, C, Swallow, CJ, Bagaria, S, Canter, R, Mullen, J, Gelderblom, HJ, Pennacchioli, E, Van Coevorden, F, Cardona, K, Fiore, M, Fairweather, M & Gronchi, A 2019, 'Predicting survival in patients undergoing resection for locally recurrent retroperitoneal sarcoma: A study and novel nomogram from TARPSWG', Clinical Cancer Research, vol. 25, no. 8, pp. 2664-2671. https://doi.org/10.1158/1078-0432.CCR-18-2700
Raut, Chandrajit P. ; Callegaro, Dario ; Miceli, Rosalba ; Barretta, Francesco ; Rutkowski, Piotr ; Blay, Jean Yves ; Lahat, Guy ; Strauss, Dirk C. ; Gonzalez, Ricardo ; Ahuja, Nita ; Grignani, Giovanni ; Quagliuolo, Vittorio ; Stoeckle, Eberhard ; De Paoli, Antonino ; Pillarisetty, Venu G. ; Nessim, Carolyn ; Swallow, Carol J. ; Bagaria, Sanjay ; Canter, Robert ; Mullen, John ; Gelderblom, Hans J. ; Pennacchioli, Elisabetta ; Van Coevorden, Frits ; Cardona, Kenneth ; Fiore, Marco ; Fairweather, Mark ; Gronchi, Alessandro. / Predicting survival in patients undergoing resection for locally recurrent retroperitoneal sarcoma : A study and novel nomogram from TARPSWG. In: Clinical Cancer Research. 2019 ; Vol. 25, No. 8. pp. 2664-2671.
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abstract = "Purpose: The role of surgery for first relapse locally recurrent retroperitoneal sarcoma (RPS-LR1) is uncertain. We report outcomes of the largest RPS-LR1 series and propose a new prognostic nomogram. Experimental Design: Patients with consecutive RPS-LR1 without distant metastases who underwent resection at 22 centers (2002-2011) were included. Endpoints were diseasefree and overall survival (DFS, OS) and crude-cumulativeincidence (CCI) of local/distant recurrence from second surgery. Nomograms predicting DFS and OS from second surgery were developed and validated (calibration plots); discrimination was assessed (Harrell C index). Results: Of 684 patients identified, full prognostic variable data were available for 602. Initial surgery for primary RPS was performed at our institutions in 188 patients (31{\%}) and elsewhere in 414 (69{\%}). At a median follow-up of 119 months [Interquartile range (IQR), 80-169] from initial surgery and 75 months (IQR 50-105) from second surgery, 6-year DFS and OS were 19.2{\%} [95{\%} confidence interval (CI), 16.0-23.0{\%}] and 54.1{\%} (95{\%} CI, 49.8-58.8{\%}), respectively. Recurrence patterns and survival probability were histology-specific, with liposarcoma subtypes having the highest 6-year CCI of second local recurrence (LR, 60.2{\%}-70.9{\%}) and leiomyosarcoma (LMS) having higher 6-year CCI of distant metastasis (DM, 36.3{\%}). Nomograms included age at second surgery, multifocality, grade, completeness of second surgery, histology, chemotherapy/radiotherapy at first surgery, and number of organs resected at first surgery. OS and DFS nomograms showed good calibration and discriminative ability (C index 0.70 and 0.67, respectively). Conclusions: We developed nomograms to predict DFS and OS for patients undergoing RPS-LR1 resection. Nomograms provide individualized, disease-relevant estimations of survival for RPS-LR1 patients and assist in clinical decisions.",
author = "Raut, {Chandrajit P.} and Dario Callegaro and Rosalba Miceli and Francesco Barretta and Piotr Rutkowski and Blay, {Jean Yves} and Guy Lahat and Strauss, {Dirk C.} and Ricardo Gonzalez and Nita Ahuja and Giovanni Grignani and Vittorio Quagliuolo and Eberhard Stoeckle and {De Paoli}, Antonino and Pillarisetty, {Venu G.} and Carolyn Nessim and Swallow, {Carol J.} and Sanjay Bagaria and Robert Canter and John Mullen and Gelderblom, {Hans J.} and Elisabetta Pennacchioli and {Van Coevorden}, Frits and Kenneth Cardona and Marco Fiore and Mark Fairweather and Alessandro Gronchi",
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TY - JOUR

T1 - Predicting survival in patients undergoing resection for locally recurrent retroperitoneal sarcoma

T2 - A study and novel nomogram from TARPSWG

AU - Raut, Chandrajit P.

AU - Callegaro, Dario

AU - Miceli, Rosalba

AU - Barretta, Francesco

AU - Rutkowski, Piotr

AU - Blay, Jean Yves

AU - Lahat, Guy

AU - Strauss, Dirk C.

AU - Gonzalez, Ricardo

AU - Ahuja, Nita

AU - Grignani, Giovanni

AU - Quagliuolo, Vittorio

AU - Stoeckle, Eberhard

AU - De Paoli, Antonino

AU - Pillarisetty, Venu G.

AU - Nessim, Carolyn

AU - Swallow, Carol J.

AU - Bagaria, Sanjay

AU - Canter, Robert

AU - Mullen, John

AU - Gelderblom, Hans J.

AU - Pennacchioli, Elisabetta

AU - Van Coevorden, Frits

AU - Cardona, Kenneth

AU - Fiore, Marco

AU - Fairweather, Mark

AU - Gronchi, Alessandro

PY - 2019/4/15

Y1 - 2019/4/15

N2 - Purpose: The role of surgery for first relapse locally recurrent retroperitoneal sarcoma (RPS-LR1) is uncertain. We report outcomes of the largest RPS-LR1 series and propose a new prognostic nomogram. Experimental Design: Patients with consecutive RPS-LR1 without distant metastases who underwent resection at 22 centers (2002-2011) were included. Endpoints were diseasefree and overall survival (DFS, OS) and crude-cumulativeincidence (CCI) of local/distant recurrence from second surgery. Nomograms predicting DFS and OS from second surgery were developed and validated (calibration plots); discrimination was assessed (Harrell C index). Results: Of 684 patients identified, full prognostic variable data were available for 602. Initial surgery for primary RPS was performed at our institutions in 188 patients (31%) and elsewhere in 414 (69%). At a median follow-up of 119 months [Interquartile range (IQR), 80-169] from initial surgery and 75 months (IQR 50-105) from second surgery, 6-year DFS and OS were 19.2% [95% confidence interval (CI), 16.0-23.0%] and 54.1% (95% CI, 49.8-58.8%), respectively. Recurrence patterns and survival probability were histology-specific, with liposarcoma subtypes having the highest 6-year CCI of second local recurrence (LR, 60.2%-70.9%) and leiomyosarcoma (LMS) having higher 6-year CCI of distant metastasis (DM, 36.3%). Nomograms included age at second surgery, multifocality, grade, completeness of second surgery, histology, chemotherapy/radiotherapy at first surgery, and number of organs resected at first surgery. OS and DFS nomograms showed good calibration and discriminative ability (C index 0.70 and 0.67, respectively). Conclusions: We developed nomograms to predict DFS and OS for patients undergoing RPS-LR1 resection. Nomograms provide individualized, disease-relevant estimations of survival for RPS-LR1 patients and assist in clinical decisions.

AB - Purpose: The role of surgery for first relapse locally recurrent retroperitoneal sarcoma (RPS-LR1) is uncertain. We report outcomes of the largest RPS-LR1 series and propose a new prognostic nomogram. Experimental Design: Patients with consecutive RPS-LR1 without distant metastases who underwent resection at 22 centers (2002-2011) were included. Endpoints were diseasefree and overall survival (DFS, OS) and crude-cumulativeincidence (CCI) of local/distant recurrence from second surgery. Nomograms predicting DFS and OS from second surgery were developed and validated (calibration plots); discrimination was assessed (Harrell C index). Results: Of 684 patients identified, full prognostic variable data were available for 602. Initial surgery for primary RPS was performed at our institutions in 188 patients (31%) and elsewhere in 414 (69%). At a median follow-up of 119 months [Interquartile range (IQR), 80-169] from initial surgery and 75 months (IQR 50-105) from second surgery, 6-year DFS and OS were 19.2% [95% confidence interval (CI), 16.0-23.0%] and 54.1% (95% CI, 49.8-58.8%), respectively. Recurrence patterns and survival probability were histology-specific, with liposarcoma subtypes having the highest 6-year CCI of second local recurrence (LR, 60.2%-70.9%) and leiomyosarcoma (LMS) having higher 6-year CCI of distant metastasis (DM, 36.3%). Nomograms included age at second surgery, multifocality, grade, completeness of second surgery, histology, chemotherapy/radiotherapy at first surgery, and number of organs resected at first surgery. OS and DFS nomograms showed good calibration and discriminative ability (C index 0.70 and 0.67, respectively). Conclusions: We developed nomograms to predict DFS and OS for patients undergoing RPS-LR1 resection. Nomograms provide individualized, disease-relevant estimations of survival for RPS-LR1 patients and assist in clinical decisions.

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