Neoadjuvant Chemotherapy for Retroperitoneal Sarcoma: A Systematic Review and Meta-Analysis

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2025-07-10 DOI:10.1002/jso.70037

Bernardo Fontel Pompeu, Luiza Soares Guerra, Julia Hoici Brunini, Gabriel Leal Barone, Lucas Monteiro Delgado, Maria Letícia Gobo Silva, Fernando Augusto Batista Campos, Samuel Aguiar Junior

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Abstract

Introduction

Retroperitoneal sarcoma is a rare malignancy, and surgical resection remains the primary treatment option. While neoadjuvant radiotherapy has shown limited long-term benefits, the role of neoadjuvant chemotherapy in this setting remains uncertain. This study aimed to evaluate the impact of neoadjuvant chemotherapy on survival outcomes in patients with resectable retroperitoneal sarcoma.

Methods

A comprehensive search was performed in PubMed, Scopus, the Central Register of Clinical Trials, and Web of Science for studies published up to December 2024. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model, and heterogeneity was assessed using I² statistics. Statistical analyses were conducted using R Software version 4.4.1 (R Foundation for Statistical Computing).

Results

Four retrospective studies were included, comprising a total of 2156 patients with resectable retroperitoneal sarcoma, of whom 361 (16.7%) received neoadjuvant chemotherapy. The analysis showed no significant difference in 5-year overall survival between patients who underwent neoadjuvant chemotherapy and those who did not. A sensitivity analysis, performed after excluding the study contributing most to heterogeneity, revealed a statistically significant 18% higher risk of mortality in patients receiving neoadjuvant chemotherapy (HR 1.18; 95% CI 1.06–1.32). Heterogeneity dropped to I² = 0% in this analysis.

Conclusion

These findings suggest that neoadjuvant chemotherapy may be associated with worse survival outcomes, although these results remain exploratory due to the retrospective nature of the included studies and the limited number of available datasets. Ongoing prospective trials, such as the STRASS2 trial, will be critical to further defining the role of neoadjuvant chemotherapy in retroperitoneal sarcoma management.

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查看原文本刊更多论文

腹膜后肉瘤的新辅助化疗：系统回顾和荟萃分析。

腹膜后肉瘤是一种罕见的恶性肿瘤，手术切除仍然是主要的治疗选择。虽然新辅助放疗显示出有限的长期益处，但新辅助化疗在这种情况下的作用仍然不确定。本研究旨在评估新辅助化疗对可切除腹膜后肉瘤患者生存结局的影响。方法：综合检索PubMed、Scopus、Central Register of Clinical Trials和Web of Science，检索截止到2024年12月发表的研究。采用随机效应模型合并95%置信区间（ci）的风险比（hr），采用I²统计量评估异质性。采用R软件4.4.1版（R Foundation for Statistical Computing）进行统计分析。结果：纳入4项回顾性研究，共纳入2156例可切除腹膜后肉瘤患者，其中361例（16.7%）接受了新辅助化疗。分析显示，接受新辅助化疗的患者和未接受新辅助化疗的患者的5年总生存率无显著差异。在排除异质性最大的研究后进行敏感性分析，发现接受新辅助化疗的患者死亡风险增加18% (HR 1.18；95% ci 1.06-1.32)。异质性在本分析中降至I²= 0%。结论：这些发现表明，新辅助化疗可能与较差的生存结果相关，尽管由于纳入研究的回顾性性质和可用数据集的数量有限，这些结果仍然是探索性的。正在进行的前瞻性试验，如STRASS2试验，将对进一步确定新辅助化疗在腹膜后肉瘤治疗中的作用至关重要。

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

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.