Marie-Pierre Sunyach, Amélie Lusque, Cécile Le Péchoux, Antonin Levy, Paul Sargos, Sylvie Helfre, Juliette Thariat, Laurence Moureau Zabotto, Delphine Lerouge, Carmen Llacer, Augustin Mervoyer, Guillaume Vogin, Christine Chevreau, Françoise Ducimetière, Jean-Yves Blay, Martine Delannes, Anne Ducassou
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引用次数: 0
Abstract
Objectives: We aim to report the outcomes of soft tissue sarcoma (STS) patients with surgical R0 margin size (large: ≥5mm or close: ≥1 to < 5mm) tumor, treated or not with postoperative radiotherapy (RT).
Methods: The Connective Tissue Cancer Network database CONTICABASE collected data from adult patients diagnosed from 1999 to 2016 for histologically-proven locally advanced STS of trunk or limbs, with surgical R0 margin size (large: ≥5mm; close: ≥1 to < 5mm), who did not receive neoadjuvant/adjuvant chemotherapy. A propensity score matching analysis was performed to account for potential treatment selection biases. We reported local control (LC), disease-free survival (DFS), overall survival (OS), RT impact in subgroup analyses, and performed multivariable analyses adjusted for classical prognostic factors.
Results: Among 738 patients with STS eligible from 11 sites, 524 patients had R0 surgical margins, either treated with postoperative RT (N = 374, 71.4%), or not (N = 150). Besides similar characteristics regarding sex, age, margin size, and preoperative MRI assessment, more tumor localizations in lower limbs (62.8% vs 46%), larger tumors (≥5cm) (68.4% vs 46%), deeper tumors (75.9% vs 56%), and more grade ≥3 tumors (50.4% vs 32.7%) were reported in patients having received adjuvant RT.The median follow-up was 74.7 [95%CI 71.8-83.0] months, 10-year-LC, -DFS, and -OS were 77.5% [95%CI 71.2-82.6], 51.0% [45.1-56.7] and 69.6% [63.7-74.6], respectively. The multivariable analysis showed that patients with older age and larger tumors are more at risk in terms of LC, DFS, and OS; Preoperative MRI assessment (HR 0.43, 95%CI 0.22-0.83; p = 0.012) and RT (HR 0.27, 95%CI 0.15-0.49; p < 0.001) were significantly associated with better LC. However, RT did not impact OS. Subgroup analyses showed that RT also benefit to grade 1 and 2 tumors.
Conclusion: This series shows that adjuvant RT improved LC in all patients with STS with surgical R0 resection.
Advances in knowledge: This series did not identify subgroups in whom RT can be deleted.
期刊介绍:
BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences.
Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896.
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- 2015 Impact Factor – 1.840
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- ISSN: 0007-1285
- eISSN: 1748-880X
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