Prognostic factors and impact of adjuvant treatments on local and metastatic relapse of soft‐tissue sarcoma patients in the competing risks setting
BACKGROUND In the medical literature many analyses of outcomes of sarcoma patients were performed without regard to the problem of “competing risks.” METHODS We analyzed local relapse–free and metastasis‐free survival in a population of 3255 adult patients with a primary soft‐tissue sarcoma (STS) in...
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| Veröffentlicht in: | Cancer 2014-11, Vol.120 (21), p.3361-3369 |
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| creator | Italiano, Antoine Cesne, Axel Mendiboure, Jean Blay, Jean‐Yves Piperno‐Neumann, Sophie Chevreau, Christine Delcambre, Corinne Penel, Nicolas Terrier, Philippe Ranchere‐Vince, Dominique Lae, Marick Guellec, Sophie Michels, Jean‐Jacques Robin, Yves Marie Bellera, Carine Bonvalot, Sylvie |
| description | BACKGROUND
In the medical literature many analyses of outcomes of sarcoma patients were performed without regard to the problem of “competing risks.”
METHODS
We analyzed local relapse–free and metastasis‐free survival in a population of 3255 adult patients with a primary soft‐tissue sarcoma (STS) included in the French Sarcoma Group database. Cumulative incidence of local and metastatic relapse was estimated by accounting for death as a competing event.
RESULTS
On multivariate analysis, age, tumor site, histological subtype, and grade were independent adverse prognostic factors for local relapse, whereas tumor depth and size had no influence. Histological subtype, tumor depth, tumor size, and grade were independent adverse prognostic factors for metastatic relapse. Despite a higher incidence of competing deaths in patients managed with adjuvant radiotherapy than in patients not receiving radiotherapy, adjuvant radiotherapy was associated with a significant benefit in terms of local relapse–free survival. Despite a similar cumulative incidence of competing deaths in patients with grade 2 and grade 3 disease, we found that the benefit of adjuvant chemotherapy was present only in patients with grade 3 and not in patients with grade 2 disease.
CONCLUSIONS
In the setting of competing risks, tumor biology reflected by histological grade is a crucial predictor of local relapse, whereas tumor depth and size have poor if any influence. Grade could also predict the benefit of adjuvant chemotherapy in patients with STS. Cancer 2014;120:3361–3369. © 2014 American Cancer Society.
In the setting of competing risks, tumor biology reflected by histological grade is a crucial predictor of local relapse of soft‐tissue sarcomas, whereas tumor depth and size have poor if any influence. Grade could also predict the benefit of adjuvant chemotherapy in patients with soft‐tissue sarcoma. |
| doi_str_mv | 10.1002/cncr.28885 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1615262016</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1615262016</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4585-538f4dc72bbec5dd5c140b9f4e51d75509e6ef99bafc959a0e94dc2b6c9011f13</originalsourceid><addsrcrecordid>eNp90cFu1DAQBmALgei2cOEBkC9IqFKK7cRJfEQraJEqihBI3CLHGReXxA4eB9Qbj9ALL8iT4OwucONkjfXNP9IMIU84O-OMiRfGm3gm2raV98iGM9UUjFfiPtkwxtpCVuWnI3KMeJPLRsjyITkSklWiUWpDfr6L4doHTM5Qq00KEan2A3XTnCsaLNXDzfJN-0RTBJ0m8Alp8HQMRo87OkHSmPSaEGHUM8LahsGmXz_ukkNcgKKOJkyazpntEpyn6TPQ_DlDcv6aRodfkCKktXpEHlg9Ijw-vCfk4-tXH7YXxeXV-Zvty8vCVLKVhSxbWw2mEX0PRg6DNLxivbIVSD40UjIFNVilem2NkkozUJmLvjaKcW55eUKe73PnGL4ugKmbHBoYR-0hLNjxmktRC8brTE_31MSAGMF2c3STjrcdZ916hm49Q7c7Q8ZPD7lLP8Hwl_7ZewbPDkBj3qON2huH_1yrqrKsmuz43n13I9z-Z2S3fbt9vx_-GwkTpOY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1615262016</pqid></control><display><type>article</type><title>Prognostic factors and impact of adjuvant treatments on local and metastatic relapse of soft‐tissue sarcoma patients in the competing risks setting</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Wiley Online Library (Open Access Collection)</source><source>Alma/SFX Local Collection</source><creator>Italiano, Antoine ; Cesne, Axel ; Mendiboure, Jean ; Blay, Jean‐Yves ; Piperno‐Neumann, Sophie ; Chevreau, Christine ; Delcambre, Corinne ; Penel, Nicolas ; Terrier, Philippe ; Ranchere‐Vince, Dominique ; Lae, Marick ; Guellec, Sophie ; Michels, Jean‐Jacques ; Robin, Yves Marie ; Bellera, Carine ; Bonvalot, Sylvie</creator><creatorcontrib>Italiano, Antoine ; Cesne, Axel ; Mendiboure, Jean ; Blay, Jean‐Yves ; Piperno‐Neumann, Sophie ; Chevreau, Christine ; Delcambre, Corinne ; Penel, Nicolas ; Terrier, Philippe ; Ranchere‐Vince, Dominique ; Lae, Marick ; Guellec, Sophie ; Michels, Jean‐Jacques ; Robin, Yves Marie ; Bellera, Carine ; Bonvalot, Sylvie</creatorcontrib><description>BACKGROUND
In the medical literature many analyses of outcomes of sarcoma patients were performed without regard to the problem of “competing risks.”
METHODS
We analyzed local relapse–free and metastasis‐free survival in a population of 3255 adult patients with a primary soft‐tissue sarcoma (STS) included in the French Sarcoma Group database. Cumulative incidence of local and metastatic relapse was estimated by accounting for death as a competing event.
RESULTS
On multivariate analysis, age, tumor site, histological subtype, and grade were independent adverse prognostic factors for local relapse, whereas tumor depth and size had no influence. Histological subtype, tumor depth, tumor size, and grade were independent adverse prognostic factors for metastatic relapse. Despite a higher incidence of competing deaths in patients managed with adjuvant radiotherapy than in patients not receiving radiotherapy, adjuvant radiotherapy was associated with a significant benefit in terms of local relapse–free survival. Despite a similar cumulative incidence of competing deaths in patients with grade 2 and grade 3 disease, we found that the benefit of adjuvant chemotherapy was present only in patients with grade 3 and not in patients with grade 2 disease.
CONCLUSIONS
In the setting of competing risks, tumor biology reflected by histological grade is a crucial predictor of local relapse, whereas tumor depth and size have poor if any influence. Grade could also predict the benefit of adjuvant chemotherapy in patients with STS. Cancer 2014;120:3361–3369. © 2014 American Cancer Society.
In the setting of competing risks, tumor biology reflected by histological grade is a crucial predictor of local relapse of soft‐tissue sarcomas, whereas tumor depth and size have poor if any influence. Grade could also predict the benefit of adjuvant chemotherapy in patients with soft‐tissue sarcoma.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.28885</identifier><identifier>PMID: 25042799</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken, NJ: Wiley-Blackwell</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Chemoradiotherapy, Adjuvant ; competing risks ; Dermatology ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Neoplasm Metastasis ; Neoplasm Recurrence, Local - drug therapy ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - radiotherapy ; Prognosis ; Risk Factors ; Sarcoma - drug therapy ; Sarcoma - mortality ; Sarcoma - pathology ; Sarcoma - radiotherapy ; soft‐tissue sarcoma ; treatment ; Treatment Outcome ; Tumors ; Tumors of the skin and soft tissue. Premalignant lesions</subject><ispartof>Cancer, 2014-11, Vol.120 (21), p.3361-3369</ispartof><rights>2014 American Cancer Society</rights><rights>2015 INIST-CNRS</rights><rights>2014 American Cancer Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4585-538f4dc72bbec5dd5c140b9f4e51d75509e6ef99bafc959a0e94dc2b6c9011f13</citedby><cites>FETCH-LOGICAL-c4585-538f4dc72bbec5dd5c140b9f4e51d75509e6ef99bafc959a0e94dc2b6c9011f13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.28885$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.28885$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,1434,27929,27930,45579,45580,46414,46838</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28943347$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25042799$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Italiano, Antoine</creatorcontrib><creatorcontrib>Cesne, Axel</creatorcontrib><creatorcontrib>Mendiboure, Jean</creatorcontrib><creatorcontrib>Blay, Jean‐Yves</creatorcontrib><creatorcontrib>Piperno‐Neumann, Sophie</creatorcontrib><creatorcontrib>Chevreau, Christine</creatorcontrib><creatorcontrib>Delcambre, Corinne</creatorcontrib><creatorcontrib>Penel, Nicolas</creatorcontrib><creatorcontrib>Terrier, Philippe</creatorcontrib><creatorcontrib>Ranchere‐Vince, Dominique</creatorcontrib><creatorcontrib>Lae, Marick</creatorcontrib><creatorcontrib>Guellec, Sophie</creatorcontrib><creatorcontrib>Michels, Jean‐Jacques</creatorcontrib><creatorcontrib>Robin, Yves Marie</creatorcontrib><creatorcontrib>Bellera, Carine</creatorcontrib><creatorcontrib>Bonvalot, Sylvie</creatorcontrib><title>Prognostic factors and impact of adjuvant treatments on local and metastatic relapse of soft‐tissue sarcoma patients in the competing risks setting</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND
In the medical literature many analyses of outcomes of sarcoma patients were performed without regard to the problem of “competing risks.”
METHODS
We analyzed local relapse–free and metastasis‐free survival in a population of 3255 adult patients with a primary soft‐tissue sarcoma (STS) included in the French Sarcoma Group database. Cumulative incidence of local and metastatic relapse was estimated by accounting for death as a competing event.
RESULTS
On multivariate analysis, age, tumor site, histological subtype, and grade were independent adverse prognostic factors for local relapse, whereas tumor depth and size had no influence. Histological subtype, tumor depth, tumor size, and grade were independent adverse prognostic factors for metastatic relapse. Despite a higher incidence of competing deaths in patients managed with adjuvant radiotherapy than in patients not receiving radiotherapy, adjuvant radiotherapy was associated with a significant benefit in terms of local relapse–free survival. Despite a similar cumulative incidence of competing deaths in patients with grade 2 and grade 3 disease, we found that the benefit of adjuvant chemotherapy was present only in patients with grade 3 and not in patients with grade 2 disease.
CONCLUSIONS
In the setting of competing risks, tumor biology reflected by histological grade is a crucial predictor of local relapse, whereas tumor depth and size have poor if any influence. Grade could also predict the benefit of adjuvant chemotherapy in patients with STS. Cancer 2014;120:3361–3369. © 2014 American Cancer Society.
In the setting of competing risks, tumor biology reflected by histological grade is a crucial predictor of local relapse of soft‐tissue sarcomas, whereas tumor depth and size have poor if any influence. Grade could also predict the benefit of adjuvant chemotherapy in patients with soft‐tissue sarcoma.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Chemoradiotherapy, Adjuvant</subject><subject>competing risks</subject><subject>Dermatology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</subject><subject>Neoplasm Metastasis</subject><subject>Neoplasm Recurrence, Local - drug therapy</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - radiotherapy</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Sarcoma - drug therapy</subject><subject>Sarcoma - mortality</subject><subject>Sarcoma - pathology</subject><subject>Sarcoma - radiotherapy</subject><subject>soft‐tissue sarcoma</subject><subject>treatment</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Tumors of the skin and soft tissue. Premalignant lesions</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90cFu1DAQBmALgei2cOEBkC9IqFKK7cRJfEQraJEqihBI3CLHGReXxA4eB9Qbj9ALL8iT4OwucONkjfXNP9IMIU84O-OMiRfGm3gm2raV98iGM9UUjFfiPtkwxtpCVuWnI3KMeJPLRsjyITkSklWiUWpDfr6L4doHTM5Qq00KEan2A3XTnCsaLNXDzfJN-0RTBJ0m8Alp8HQMRo87OkHSmPSaEGHUM8LahsGmXz_ukkNcgKKOJkyazpntEpyn6TPQ_DlDcv6aRodfkCKktXpEHlg9Ijw-vCfk4-tXH7YXxeXV-Zvty8vCVLKVhSxbWw2mEX0PRg6DNLxivbIVSD40UjIFNVilem2NkkozUJmLvjaKcW55eUKe73PnGL4ugKmbHBoYR-0hLNjxmktRC8brTE_31MSAGMF2c3STjrcdZ916hm49Q7c7Q8ZPD7lLP8Hwl_7ZewbPDkBj3qON2huH_1yrqrKsmuz43n13I9z-Z2S3fbt9vx_-GwkTpOY</recordid><startdate>20141101</startdate><enddate>20141101</enddate><creator>Italiano, Antoine</creator><creator>Cesne, Axel</creator><creator>Mendiboure, Jean</creator><creator>Blay, Jean‐Yves</creator><creator>Piperno‐Neumann, Sophie</creator><creator>Chevreau, Christine</creator><creator>Delcambre, Corinne</creator><creator>Penel, Nicolas</creator><creator>Terrier, Philippe</creator><creator>Ranchere‐Vince, Dominique</creator><creator>Lae, Marick</creator><creator>Guellec, Sophie</creator><creator>Michels, Jean‐Jacques</creator><creator>Robin, Yves Marie</creator><creator>Bellera, Carine</creator><creator>Bonvalot, Sylvie</creator><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20141101</creationdate><title>Prognostic factors and impact of adjuvant treatments on local and metastatic relapse of soft‐tissue sarcoma patients in the competing risks setting</title><author>Italiano, Antoine ; Cesne, Axel ; Mendiboure, Jean ; Blay, Jean‐Yves ; Piperno‐Neumann, Sophie ; Chevreau, Christine ; Delcambre, Corinne ; Penel, Nicolas ; Terrier, Philippe ; Ranchere‐Vince, Dominique ; Lae, Marick ; Guellec, Sophie ; Michels, Jean‐Jacques ; Robin, Yves Marie ; Bellera, Carine ; Bonvalot, Sylvie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4585-538f4dc72bbec5dd5c140b9f4e51d75509e6ef99bafc959a0e94dc2b6c9011f13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Chemoradiotherapy, Adjuvant</topic><topic>competing risks</topic><topic>Dermatology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</topic><topic>Neoplasm Metastasis</topic><topic>Neoplasm Recurrence, Local - drug therapy</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - radiotherapy</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Sarcoma - drug therapy</topic><topic>Sarcoma - mortality</topic><topic>Sarcoma - pathology</topic><topic>Sarcoma - radiotherapy</topic><topic>soft‐tissue sarcoma</topic><topic>treatment</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Tumors of the skin and soft tissue. Premalignant lesions</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Italiano, Antoine</creatorcontrib><creatorcontrib>Cesne, Axel</creatorcontrib><creatorcontrib>Mendiboure, Jean</creatorcontrib><creatorcontrib>Blay, Jean‐Yves</creatorcontrib><creatorcontrib>Piperno‐Neumann, Sophie</creatorcontrib><creatorcontrib>Chevreau, Christine</creatorcontrib><creatorcontrib>Delcambre, Corinne</creatorcontrib><creatorcontrib>Penel, Nicolas</creatorcontrib><creatorcontrib>Terrier, Philippe</creatorcontrib><creatorcontrib>Ranchere‐Vince, Dominique</creatorcontrib><creatorcontrib>Lae, Marick</creatorcontrib><creatorcontrib>Guellec, Sophie</creatorcontrib><creatorcontrib>Michels, Jean‐Jacques</creatorcontrib><creatorcontrib>Robin, Yves Marie</creatorcontrib><creatorcontrib>Bellera, Carine</creatorcontrib><creatorcontrib>Bonvalot, Sylvie</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Italiano, Antoine</au><au>Cesne, Axel</au><au>Mendiboure, Jean</au><au>Blay, Jean‐Yves</au><au>Piperno‐Neumann, Sophie</au><au>Chevreau, Christine</au><au>Delcambre, Corinne</au><au>Penel, Nicolas</au><au>Terrier, Philippe</au><au>Ranchere‐Vince, Dominique</au><au>Lae, Marick</au><au>Guellec, Sophie</au><au>Michels, Jean‐Jacques</au><au>Robin, Yves Marie</au><au>Bellera, Carine</au><au>Bonvalot, Sylvie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic factors and impact of adjuvant treatments on local and metastatic relapse of soft‐tissue sarcoma patients in the competing risks setting</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2014-11-01</date><risdate>2014</risdate><volume>120</volume><issue>21</issue><spage>3361</spage><epage>3369</epage><pages>3361-3369</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND
In the medical literature many analyses of outcomes of sarcoma patients were performed without regard to the problem of “competing risks.”
METHODS
We analyzed local relapse–free and metastasis‐free survival in a population of 3255 adult patients with a primary soft‐tissue sarcoma (STS) included in the French Sarcoma Group database. Cumulative incidence of local and metastatic relapse was estimated by accounting for death as a competing event.
RESULTS
On multivariate analysis, age, tumor site, histological subtype, and grade were independent adverse prognostic factors for local relapse, whereas tumor depth and size had no influence. Histological subtype, tumor depth, tumor size, and grade were independent adverse prognostic factors for metastatic relapse. Despite a higher incidence of competing deaths in patients managed with adjuvant radiotherapy than in patients not receiving radiotherapy, adjuvant radiotherapy was associated with a significant benefit in terms of local relapse–free survival. Despite a similar cumulative incidence of competing deaths in patients with grade 2 and grade 3 disease, we found that the benefit of adjuvant chemotherapy was present only in patients with grade 3 and not in patients with grade 2 disease.
CONCLUSIONS
In the setting of competing risks, tumor biology reflected by histological grade is a crucial predictor of local relapse, whereas tumor depth and size have poor if any influence. Grade could also predict the benefit of adjuvant chemotherapy in patients with STS. Cancer 2014;120:3361–3369. © 2014 American Cancer Society.
In the setting of competing risks, tumor biology reflected by histological grade is a crucial predictor of local relapse of soft‐tissue sarcomas, whereas tumor depth and size have poor if any influence. Grade could also predict the benefit of adjuvant chemotherapy in patients with soft‐tissue sarcoma.</abstract><cop>Hoboken, NJ</cop><pub>Wiley-Blackwell</pub><pmid>25042799</pmid><doi>10.1002/cncr.28885</doi><tpages>10</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Biological and medical sciences Chemoradiotherapy, Adjuvant competing risks Dermatology Female Humans Male Medical sciences Middle Aged Multiple tumors. Solid tumors. Tumors in childhood (general aspects) Neoplasm Metastasis Neoplasm Recurrence, Local - drug therapy Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - radiotherapy Prognosis Risk Factors Sarcoma - drug therapy Sarcoma - mortality Sarcoma - pathology Sarcoma - radiotherapy soft‐tissue sarcoma treatment Treatment Outcome Tumors Tumors of the skin and soft tissue. Premalignant lesions |
| title | Prognostic factors and impact of adjuvant treatments on local and metastatic relapse of soft‐tissue sarcoma patients in the competing risks setting |
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