Postoperative radiotherapy in patients with R0 resection of soft tissue sarcoma: results from the European sarcoma CONTICABASE analysis.

IF 1.8 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

British Journal of Radiology Pub Date : 2025-07-03 DOI:10.1093/bjr/tqaf068

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.

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R0软组织肉瘤切除术患者的术后放疗：来自欧洲肉瘤CONTICABASE分析的结果

目的：我们的目的是报告手术R0切缘（大：≥5mm或接近：≥1）的软组织肉瘤（STS）患者的结局。方法：结缔组织癌症网络数据库CONTICABASE收集了1999年至2016年诊断的成人患者的数据，这些患者的手术R0切缘(大：≥5mm；结果：在来自11个地点的738例符合STS条件的患者中，524例患者的R0手术切缘，要么接受术后RT治疗（N = 374,71.4%），要么不接受RT治疗（N = 150）。除了在性别、年龄、切缘大小和术前MRI评估方面的相似特征外，接受辅助放疗的患者中，更多的肿瘤定位于下肢（62.8%比46%）、更大的肿瘤（≥5cm）（68.4%比46%）、更深的肿瘤（75.9%比56%）和更多≥3级肿瘤（50.4%比32.7%）。中位随访时间为74.7 [95%CI 71.8-83.0]个月，10年lc、-DFS和-OS分别为77.5% [95%CI 71.2-82.6]、51.0%[45.1-56.7]和69.6%[63.7-74.6]。多变量分析显示，年龄越大、肿瘤越大的患者在LC、DFS和OS方面的风险更高；术前MRI评估(HR 0.43, 95%CI 0.22-0.83；p = 0.012)和RT (HR 0.27, 95%CI 0.15 ~ 0.49；结论：这一系列研究表明，辅助放疗改善了所有手术切除STS患者的LC。知识进展：本系列没有发现可以删除RT的亚组。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Radiology 医学-核医学

CiteScore

5.30

自引率

3.80%

发文量

330

审稿时长

2-4 weeks

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. Quick Facts: - 2015 Impact Factor – 1.840 - Receipt to first decision – average of 6 weeks - Acceptance to online publication – average of 3 weeks - ISSN: 0007-1285 - eISSN: 1748-880X Open Access option