Analysis of perioperative radiation therapy in the surgical treatment of primary and recurrent retroperitoneal sarcoma
Background Radiation therapy (RT) is increasingly utilized in conjunction with surgery for the treatment of retroperitoneal soft tissue sarcomas (RPS). Despite multiple theoretical advantages of RT, its role in the surgical management of this disease remains ill defined. Methods Patients undergoing...
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| Veröffentlicht in: | Journal of surgical oncology 2015-09, Vol.112 (4), p.352-358 |
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| container_title | Journal of surgical oncology |
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| creator | Lane, Whitney O. Cramer, Christina K. Nussbaum, Daniel P. Speicher, Paul J. Gulack, Brian C. Czito, Brian G. Kirsch, David G. Tyler, Douglas S. Blazer III, Dan G. |
| description | Background
Radiation therapy (RT) is increasingly utilized in conjunction with surgery for the treatment of retroperitoneal soft tissue sarcomas (RPS). Despite multiple theoretical advantages of RT, its role in the surgical management of this disease remains ill defined.
Methods
Patients undergoing surgery for RPS from 1990 to 2011 were identified. Patients were classified as having primary or recurrent disease, and then further stratified by the use of perioperative RT. Primary outcomes, including overall survival (OS) and recurrence‐free survival (RFS), were estimated using the Kaplan‐Meier method with comparisons based on the log rank test. Cox‐proportional hazards modeling was used to estimate the independent effect of RT on survival.
Results
Ninety‐four patients met final inclusion criteria. After adjusting for confounding variables, perioperative RT remained independently associated with a reduced risk of recurrence (HR 0.34, P |
| doi_str_mv | 10.1002/jso.23996 |
| format | Article |
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Radiation therapy (RT) is increasingly utilized in conjunction with surgery for the treatment of retroperitoneal soft tissue sarcomas (RPS). Despite multiple theoretical advantages of RT, its role in the surgical management of this disease remains ill defined.
Methods
Patients undergoing surgery for RPS from 1990 to 2011 were identified. Patients were classified as having primary or recurrent disease, and then further stratified by the use of perioperative RT. Primary outcomes, including overall survival (OS) and recurrence‐free survival (RFS), were estimated using the Kaplan‐Meier method with comparisons based on the log rank test. Cox‐proportional hazards modeling was used to estimate the independent effect of RT on survival.
Results
Ninety‐four patients met final inclusion criteria. After adjusting for confounding variables, perioperative RT remained independently associated with a reduced risk of recurrence (HR 0.34, P < 0.01) and death (HR 0.30, P = 0.02).
Conclusions
In this retrospective series, perioperative RT is an independent predictor of improved OS and RFS. These results provide additional support for the use of RT in the multimodality treatment of retroperitoneal sarcoma. J. Surg. Oncol. 2015; 112:352–358. © 2015 Wiley Periodicals, Inc.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.23996</identifier><identifier>PMID: 26238282</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Aged ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - radiotherapy ; Neoplasm Recurrence, Local - surgery ; Perioperative Care ; Prognosis ; radiotherapy ; Radiotherapy, Adjuvant ; Retroperitoneal Neoplasms - mortality ; Retroperitoneal Neoplasms - pathology ; Retroperitoneal Neoplasms - radiotherapy ; Retroperitoneal Neoplasms - surgery ; retroperitonealsarcoma ; Retrospective Studies ; Sarcoma - mortality ; Sarcoma - pathology ; Sarcoma - radiotherapy ; Sarcoma - surgery ; surgery ; survival analysis ; Survival Rate</subject><ispartof>Journal of surgical oncology, 2015-09, Vol.112 (4), p.352-358</ispartof><rights>2015 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4616-578a21e4089bd3cf8ff194e57d200d9597505ef750688bb7cca533de9515e53f3</citedby><cites>FETCH-LOGICAL-c4616-578a21e4089bd3cf8ff194e57d200d9597505ef750688bb7cca533de9515e53f3</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%2Fjso.23996$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.23996$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26238282$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lane, Whitney O.</creatorcontrib><creatorcontrib>Cramer, Christina K.</creatorcontrib><creatorcontrib>Nussbaum, Daniel P.</creatorcontrib><creatorcontrib>Speicher, Paul J.</creatorcontrib><creatorcontrib>Gulack, Brian C.</creatorcontrib><creatorcontrib>Czito, Brian G.</creatorcontrib><creatorcontrib>Kirsch, David G.</creatorcontrib><creatorcontrib>Tyler, Douglas S.</creatorcontrib><creatorcontrib>Blazer III, Dan G.</creatorcontrib><title>Analysis of perioperative radiation therapy in the surgical treatment of primary and recurrent retroperitoneal sarcoma</title><title>Journal of surgical oncology</title><addtitle>J. Surg. Oncol</addtitle><description>Background
Radiation therapy (RT) is increasingly utilized in conjunction with surgery for the treatment of retroperitoneal soft tissue sarcomas (RPS). Despite multiple theoretical advantages of RT, its role in the surgical management of this disease remains ill defined.
Methods
Patients undergoing surgery for RPS from 1990 to 2011 were identified. Patients were classified as having primary or recurrent disease, and then further stratified by the use of perioperative RT. Primary outcomes, including overall survival (OS) and recurrence‐free survival (RFS), were estimated using the Kaplan‐Meier method with comparisons based on the log rank test. Cox‐proportional hazards modeling was used to estimate the independent effect of RT on survival.
Results
Ninety‐four patients met final inclusion criteria. After adjusting for confounding variables, perioperative RT remained independently associated with a reduced risk of recurrence (HR 0.34, P < 0.01) and death (HR 0.30, P = 0.02).
Conclusions
In this retrospective series, perioperative RT is an independent predictor of improved OS and RFS. These results provide additional support for the use of RT in the multimodality treatment of retroperitoneal sarcoma. J. Surg. Oncol. 2015; 112:352–358. © 2015 Wiley Periodicals, Inc.</description><subject>Aged</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - radiotherapy</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Perioperative Care</subject><subject>Prognosis</subject><subject>radiotherapy</subject><subject>Radiotherapy, Adjuvant</subject><subject>Retroperitoneal Neoplasms - mortality</subject><subject>Retroperitoneal Neoplasms - pathology</subject><subject>Retroperitoneal Neoplasms - radiotherapy</subject><subject>Retroperitoneal Neoplasms - surgery</subject><subject>retroperitonealsarcoma</subject><subject>Retrospective Studies</subject><subject>Sarcoma - mortality</subject><subject>Sarcoma - pathology</subject><subject>Sarcoma - radiotherapy</subject><subject>Sarcoma - surgery</subject><subject>surgery</subject><subject>survival analysis</subject><subject>Survival Rate</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kTlv3DAQhQkjgb1xUvgPBATS2IVsHqJElsb6hrEucgFuCC41SriRxDVJOdl_H-5hFwHSDAec7z1g3iB0RMkpJYSdLaI_ZVypag9NKFFVoYiSb9Akz1hR1oocoHcxLgghmSn30QGrGJdMsgl6Ph9Mt4ouYt_iJQTnczHJPQMOpnG58wNOP_PfcoXdpsVxDD-cNR1OAUzqYUgbcXC9CStshgYHsGMI60GAFNaWLvkBsiSaYH1v3qO3rekifNi9h-jr1eWX6U1x_3B9Oz2_L2xZ0aoQtTSMQkmkmjfctrJtqSpB1A0jpFFC1YIIaHOtpJzPa2uN4LwBJagAwVt-iI63vsvgn0aISfcuWug6M4Afo6Y1rVTJc2gZ_fQPuvBjyOlsKKE4yZFl6mRL2eBjDNDq3d6aEr0-hs7H0JtjZPbjznGc99C8ki_pZ-BsC_x2Haz-76TvPj-8WBZbhYsJ_rwqTPilq5rXQn-fXetSzh7vLmZEf-N_AcLqpHM</recordid><startdate>20150915</startdate><enddate>20150915</enddate><creator>Lane, Whitney O.</creator><creator>Cramer, Christina K.</creator><creator>Nussbaum, Daniel P.</creator><creator>Speicher, Paul J.</creator><creator>Gulack, Brian C.</creator><creator>Czito, Brian G.</creator><creator>Kirsch, David G.</creator><creator>Tyler, Douglas S.</creator><creator>Blazer III, Dan G.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</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>K9.</scope><scope>7X8</scope></search><sort><creationdate>20150915</creationdate><title>Analysis of perioperative radiation therapy in the surgical treatment of primary and recurrent retroperitoneal sarcoma</title><author>Lane, Whitney O. ; Cramer, Christina K. ; Nussbaum, Daniel P. ; Speicher, Paul J. ; Gulack, Brian C. ; Czito, Brian G. ; Kirsch, David G. ; Tyler, Douglas S. ; Blazer III, Dan G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4616-578a21e4089bd3cf8ff194e57d200d9597505ef750688bb7cca533de9515e53f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - radiotherapy</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Perioperative Care</topic><topic>Prognosis</topic><topic>radiotherapy</topic><topic>Radiotherapy, Adjuvant</topic><topic>Retroperitoneal Neoplasms - mortality</topic><topic>Retroperitoneal Neoplasms - pathology</topic><topic>Retroperitoneal Neoplasms - radiotherapy</topic><topic>Retroperitoneal Neoplasms - surgery</topic><topic>retroperitonealsarcoma</topic><topic>Retrospective Studies</topic><topic>Sarcoma - mortality</topic><topic>Sarcoma - pathology</topic><topic>Sarcoma - radiotherapy</topic><topic>Sarcoma - surgery</topic><topic>surgery</topic><topic>survival analysis</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lane, Whitney O.</creatorcontrib><creatorcontrib>Cramer, Christina K.</creatorcontrib><creatorcontrib>Nussbaum, Daniel P.</creatorcontrib><creatorcontrib>Speicher, Paul J.</creatorcontrib><creatorcontrib>Gulack, Brian C.</creatorcontrib><creatorcontrib>Czito, Brian G.</creatorcontrib><creatorcontrib>Kirsch, David G.</creatorcontrib><creatorcontrib>Tyler, Douglas S.</creatorcontrib><creatorcontrib>Blazer III, Dan G.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lane, Whitney O.</au><au>Cramer, Christina K.</au><au>Nussbaum, Daniel P.</au><au>Speicher, Paul J.</au><au>Gulack, Brian C.</au><au>Czito, Brian G.</au><au>Kirsch, David G.</au><au>Tyler, Douglas S.</au><au>Blazer III, Dan G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of perioperative radiation therapy in the surgical treatment of primary and recurrent retroperitoneal sarcoma</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J. Surg. Oncol</addtitle><date>2015-09-15</date><risdate>2015</risdate><volume>112</volume><issue>4</issue><spage>352</spage><epage>358</epage><pages>352-358</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background
Radiation therapy (RT) is increasingly utilized in conjunction with surgery for the treatment of retroperitoneal soft tissue sarcomas (RPS). Despite multiple theoretical advantages of RT, its role in the surgical management of this disease remains ill defined.
Methods
Patients undergoing surgery for RPS from 1990 to 2011 were identified. Patients were classified as having primary or recurrent disease, and then further stratified by the use of perioperative RT. Primary outcomes, including overall survival (OS) and recurrence‐free survival (RFS), were estimated using the Kaplan‐Meier method with comparisons based on the log rank test. Cox‐proportional hazards modeling was used to estimate the independent effect of RT on survival.
Results
Ninety‐four patients met final inclusion criteria. After adjusting for confounding variables, perioperative RT remained independently associated with a reduced risk of recurrence (HR 0.34, P < 0.01) and death (HR 0.30, P = 0.02).
Conclusions
In this retrospective series, perioperative RT is an independent predictor of improved OS and RFS. These results provide additional support for the use of RT in the multimodality treatment of retroperitoneal sarcoma. J. Surg. Oncol. 2015; 112:352–358. © 2015 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>26238282</pmid><doi>10.1002/jso.23996</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Combined Modality Therapy Female Follow-Up Studies Humans Male Middle Aged Neoplasm Grading Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - radiotherapy Neoplasm Recurrence, Local - surgery Perioperative Care Prognosis radiotherapy Radiotherapy, Adjuvant Retroperitoneal Neoplasms - mortality Retroperitoneal Neoplasms - pathology Retroperitoneal Neoplasms - radiotherapy Retroperitoneal Neoplasms - surgery retroperitonealsarcoma Retrospective Studies Sarcoma - mortality Sarcoma - pathology Sarcoma - radiotherapy Sarcoma - surgery surgery survival analysis Survival Rate |
| title | Analysis of perioperative radiation therapy in the surgical treatment of primary and recurrent retroperitoneal sarcoma |
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