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December 16, 2024Annals of Surgical Oncology2 citationsOpen Access

The Impact of Perioperative Radiotherapy on Disease-Specific Survival in Patients with Localized Retroperitoneal Liposarcoma: A Population-Based Propensity-Score Matched Analysis

AWAlexander WilhelmBWBenjamin WieslerCKChristoph Kümmerli

Key Result

Perioperative radiotherapy did not improve disease-specific survival compared to surgery alone in patients with localized retroperitoneal liposarcoma (HR 1.04).

Study Design

Type

Cohort (n=1,692)

Multicenter

Yes

Structured PICO

Does perioperative radiotherapy improve disease-specific survival in patients undergoing surgery for localized retroperitoneal liposarcoma?

P
Population
1,692 patients with localized retroperitoneal liposarcoma (RPLS) who underwent surgical therapy, mean age 62 years, 84.2% White, 44.6% female, identified from the SEER-17 cancer registry program (US-based).
I
Intervention
Perioperative radiotherapy (including external beam radiotherapy, radioactive implants, or radioisotopes).
C
Comparator
No radiotherapy or unknown radiotherapy status.
O
Outcome
Disease-specific survival (DSS).hard clinical

In a population-based propensity-score matched analysis, perioperative radiotherapy did not improve disease-specific survival in patients undergoing surgery for localized retroperitoneal liposarcoma.

Main Result

Effect estimate: HR 1.04 (95% CI 0.81-1.32)

Absolute Event Rate: 72.5% vs 79%

p-value: p=0.47

Limitations

  • Retrospective database subject to selection bias and coding errors
  • Cannot determine causality
  • Lack of information on positive margins or R status
  • Lack of information regarding comorbidity status, performance status, facility type, multifocality, and molecular data
  • Lack of detailed information regarding treatment modalities, radiotherapy dose, radiation field, completion of radiotherapy, and number of fractions
  • SEER database does not distinguish between 'no' and 'unknown' radiotherapy status
  • Death certificates may be inaccurately classified
  • Retrospective design subject to selection bias and coding errors
  • Lack of data on positive margins or R status
  • Lack of information regarding comorbidity status, performance status, and molecular data
  • Lack of detailed information regarding radiotherapy dose, field, and completion
  • Lack of information on treatments received outside the designated catchment area

Abstract

BACKGROUND: The impact of radiotherapy on the oncologic outcome of retroperitoneal liposarcoma (RPLS) remains controversial. The aim of this study was to evaluate the effect of radiotherapy on disease-specific survival (DSS) in a cohort of patients with RPLSs. METHODS: In this population-based, retrospective cohort study, patients with localized RPLSs who underwent surgical therapy were identified from the Surveillance, Epidemiology, and End Results-17 cancer registry program. After propensity-score matching for potential confounders, multivariable logistic and Cox regression analyses were used to examine factors associated with DSS and radiotherapy. RESULTS: From 2004 to 2020, 1692 patients with localized RPLS who underwent surgical therapy were identified (84.2% White, 44.6% female, mean age 62 years). Of those patients, 393 patients (23.2%) received perioperative radiotherapy. Patients who received radiotherapy had a higher rate of tumor size between 10 and 20 cm and unknown tumor grading. After propensity-score matching, multivariable adjusted Cox regression and Kaplan-Meier survival analysis demonstrated no improvement of DSS for patients who underwent radiotherapy (hazard ratio 1.04, confidence interval 0.81-1.32; log-rank p = 0.47). Patient age ≥80 years, larger tumor size, and tumor grading G3 versus G1/2 were associated with an increased risk of death due to RPLS. Subgroup analyses stratified by grading showed similar outcomes. CONCLUSIONS: The administration of perioperative radiotherapy did not improve DSS in patients undergoing surgery for localized RPLS in this population-based study. Therefore, the use of perioperative radiotherapy in these patients may be questioned. However, the findings should be interpreted with caution due to the inherent limitations of the Surveillance, Epidemiology, and End Results (SEER) database.

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Cite This Study

Wilhelm et al. (2024) conducted a cohort in Localized Retroperitoneal Liposarcoma (n=1,692). Perioperative radiotherapy vs. No/unknown radiotherapy was evaluated on Disease-specific survival (DSS) (HR 1.04, 95% CI 0.81-1.32, p=0.47). Perioperative radiotherapy did not improve disease-specific survival compared to surgery alone in patients with localized retroperitoneal liposarcoma (HR 1.04).

synapsesocial.com/papers/6a12be4c257f24f1de9e36d4https://doi.org/10.1245/s10434-024-16703-w
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Perioperative Radiotherapy and Survival After Surgical Treatment of Nonmetastatic Retroperitoneal Sarcoma2025 · 3 citations
  2. 2Radiotherapy for retroperitoneal liposarcoma: A report from the Transatlantic Retroperitoneal Sarcoma Working Group2019 · 99 citations
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