Key result
Perioperative radiotherapy plus surgery reduces 5-year mortality ~31% vs surgery alone in retroperitoneal sarcomas.
Why the study?
There is no clear evidence on whether radiotherapy improves treatment results in patients with retroperitoneal sarcomas.
Does perioperative radiotherapy plus surgery improve overall survival in patients with retroperitoneal sarcomas compared to surgery alone?
Meta-Analysis (n=6,828)
Does perioperative radiotherapy plus surgery improve overall survival in patients with retroperitoneal sarcomas compared to surgery alone?
Perioperative radiotherapy combined with surgery is associated with improved overall survival and recurrence-free survival compared to surgery alone in patients with retroperitoneal sarcomas.
RT plus surgery improves OS and RFS versus surgery alone in RPS; supports randomized trials before routine adoption.
Background There is no clear evidence on whether radiotherapy (RT) improves treatment result in patients with retroperitoneal sarcomas (RPS). Methods A systematic literature search was performed using PubMed, Scopus and CENTRAL databases. Data were retrieved from published comparatives studies in patients with RPS undergoing surgery alone or RT plus surgery. The primary endpoints were the 5-year OS and the median OS. The secondary endpoints were the recurrence-free survival (RFS) and the R0-resection rate. Continuous outcomes were calculated by means of weighted mean difference (WMD). Results Ten out of 374 articles were analyzed. The median OS and the 5-year survival were significantly increased in patients treated with RT and surgery, compared to patients treated with surgery alone (p < 0.00001, p < 0.001). Median RFS was significantly increased in patients treated with either preoperative (p < 0.001) or postoperative (p = 0.001) RT compared to patients that underwent surgery alone. Finally, median R0-resection rate was similar between the two groups (p = 0.56). Conclusion RT along with radical surgery could be the standard of care in at least a subgroup of patients with RPS.
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Diamantis et al. (2020) conducted a meta-analysis in Retroperitoneal sarcomas (n=6,828). Perioperative radiotherapy plus surgery vs. Surgery alone was evaluated on 5-year overall survival (OR 0.69, 95% CI 0.62-0.77, p=<0.0001). Perioperative radiotherapy combined with surgery significantly improved 5-year overall survival (OR 0.69) compared to surgery alone in patients with retroperitoneal sarcomas.
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