Utilization pattern and survival outcomes of adjuvant therapies in high‐grade nonretroperitoneal abdominal soft tissue sarcoma: A population‐based study
Background Nonretroperitoneal abdominal soft tissue sarcoma (NRA‐STS) is a rare disease with limited data supporting its management. Our study aimed to reveal the utilization patterns of adjuvant therapy and its potential survival benefits using the National Cancer Data Base. Materials The analysis...
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| Veröffentlicht in: | Asia-Pacific journal of clinical oncology 2018-02, Vol.14 (1), p.101-113 |
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| creator | Green, William Ross Chokshi, Ravi Jabbour, Salma K. DeLaney, Thomas F. Mahmoud, Omar |
| description | Background
Nonretroperitoneal abdominal soft tissue sarcoma (NRA‐STS) is a rare disease with limited data supporting its management. Our study aimed to reveal the utilization patterns of adjuvant therapy and its potential survival benefits using the National Cancer Data Base.
Materials
The analysis included patients with resected high‐grade NRA‐STS. Chi‐square analysis was used to evaluate distribution of patient and tumor‐related factors within treatment groups. The Kaplan–Meier and Cox proportional hazards model were utilized to evaluate overall survival according to treatment approach. Multivariate analysis was used to determine the impact of these factors on patients’ outcome. Matched propensity score analysis was implemented to control for imbalance of confounding variables.
Results
At median follow‐up of 49 months, 5‐year overall survival improved from 46% without adjuvant radiation therapy to 52% (P = 0.009) with radiotherapy delivery with a 30% reduction in hazard of death (95% confidence interval = 0.58–0.84). On multivariate analysis, age |
| doi_str_mv | 10.1111/ajco.12683 |
| format | Article |
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Nonretroperitoneal abdominal soft tissue sarcoma (NRA‐STS) is a rare disease with limited data supporting its management. Our study aimed to reveal the utilization patterns of adjuvant therapy and its potential survival benefits using the National Cancer Data Base.
Materials
The analysis included patients with resected high‐grade NRA‐STS. Chi‐square analysis was used to evaluate distribution of patient and tumor‐related factors within treatment groups. The Kaplan–Meier and Cox proportional hazards model were utilized to evaluate overall survival according to treatment approach. Multivariate analysis was used to determine the impact of these factors on patients’ outcome. Matched propensity score analysis was implemented to control for imbalance of confounding variables.
Results
At median follow‐up of 49 months, 5‐year overall survival improved from 46% without adjuvant radiation therapy to 52% (P = 0.009) with radiotherapy delivery with a 30% reduction in hazard of death (95% confidence interval = 0.58–0.84). On multivariate analysis, age <50, tumor <8 cm, negative margins and radiotherapy delivery were significant predictors of improved survival. Chemotherapy was not associated with significant survival improvement (Hazard Ratios [HR]: 0.89, P = 0.28).
Conclusion
Adjuvant radiotherapy was associated with improved survival in high‐grade NRA‐STS. Chemotherapy was not associated with a survival improvement; however, further studies are needed to refine treatment strategies.</description><identifier>ISSN: 1743-7555</identifier><identifier>EISSN: 1743-7563</identifier><identifier>DOI: 10.1111/ajco.12683</identifier><identifier>PMID: 28464497</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Abdominal Neoplasms - mortality ; Abdominal Neoplasms - pathology ; Abdominal Neoplasms - radiotherapy ; abdominal soft tissue sarcoma ; adjuvant therapies ; Adjuvant therapy ; Age Factors ; Aged ; Chemotherapy ; Chemotherapy, Adjuvant - statistics & numerical data ; Data processing ; Databases, Factual ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; nonretroperitoneal sarcoma ; Population studies ; Population-based studies ; Practice Patterns, Physicians' - statistics & numerical data ; Proportional Hazards Models ; Radiation therapy ; Radiotherapy, Adjuvant - statistics & numerical data ; Rare diseases ; Sarcoma - drug therapy ; Sarcoma - mortality ; Sarcoma - pathology ; Sarcoma - radiotherapy ; Soft tissue sarcoma ; Survival ; survival outcomes ; United States - epidemiology</subject><ispartof>Asia-Pacific journal of clinical oncology, 2018-02, Vol.14 (1), p.101-113</ispartof><rights>2017 John Wiley & Sons Australia, Ltd</rights><rights>2017 John Wiley & Sons Australia, Ltd.</rights><rights>Copyright © 2018 John Wiley & Sons Australia, Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3723-8ec5c1b8edcb41d718c8880823ce0aaee1162891eb56021ec291c2afaa3153da3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajco.12683$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajco.12683$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,778,782,883,1414,27911,27912,45561,45562</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28464497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Green, William Ross</creatorcontrib><creatorcontrib>Chokshi, Ravi</creatorcontrib><creatorcontrib>Jabbour, Salma K.</creatorcontrib><creatorcontrib>DeLaney, Thomas F.</creatorcontrib><creatorcontrib>Mahmoud, Omar</creatorcontrib><title>Utilization pattern and survival outcomes of adjuvant therapies in high‐grade nonretroperitoneal abdominal soft tissue sarcoma: A population‐based study</title><title>Asia-Pacific journal of clinical oncology</title><addtitle>Asia Pac J Clin Oncol</addtitle><description>Background
Nonretroperitoneal abdominal soft tissue sarcoma (NRA‐STS) is a rare disease with limited data supporting its management. Our study aimed to reveal the utilization patterns of adjuvant therapy and its potential survival benefits using the National Cancer Data Base.
Materials
The analysis included patients with resected high‐grade NRA‐STS. Chi‐square analysis was used to evaluate distribution of patient and tumor‐related factors within treatment groups. The Kaplan–Meier and Cox proportional hazards model were utilized to evaluate overall survival according to treatment approach. Multivariate analysis was used to determine the impact of these factors on patients’ outcome. Matched propensity score analysis was implemented to control for imbalance of confounding variables.
Results
At median follow‐up of 49 months, 5‐year overall survival improved from 46% without adjuvant radiation therapy to 52% (P = 0.009) with radiotherapy delivery with a 30% reduction in hazard of death (95% confidence interval = 0.58–0.84). On multivariate analysis, age <50, tumor <8 cm, negative margins and radiotherapy delivery were significant predictors of improved survival. Chemotherapy was not associated with significant survival improvement (Hazard Ratios [HR]: 0.89, P = 0.28).
Conclusion
Adjuvant radiotherapy was associated with improved survival in high‐grade NRA‐STS. Chemotherapy was not associated with a survival improvement; however, further studies are needed to refine treatment strategies.</description><subject>Abdominal Neoplasms - mortality</subject><subject>Abdominal Neoplasms - pathology</subject><subject>Abdominal Neoplasms - radiotherapy</subject><subject>abdominal soft tissue sarcoma</subject><subject>adjuvant therapies</subject><subject>Adjuvant therapy</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant - statistics & numerical data</subject><subject>Data processing</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Grading</subject><subject>nonretroperitoneal sarcoma</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Proportional Hazards Models</subject><subject>Radiation therapy</subject><subject>Radiotherapy, Adjuvant - statistics & numerical data</subject><subject>Rare diseases</subject><subject>Sarcoma - drug therapy</subject><subject>Sarcoma - mortality</subject><subject>Sarcoma - pathology</subject><subject>Sarcoma - radiotherapy</subject><subject>Soft tissue sarcoma</subject><subject>Survival</subject><subject>survival outcomes</subject><subject>United States - epidemiology</subject><issn>1743-7555</issn><issn>1743-7563</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctuEzEUhi0EoqWw4QGQJXZIae3xXDxsUBSVS1WpG7q2znjOJI4m9uBLqrDqI_AAPB1PgtOUCDZ44yP793eO_5-Q15yd87wuYK3dOS9qKZ6QU96UYtZUtXh6rKvqhLwIYc2YaIuWPycnhSzrsmybU_LzNprRfIdonKUTxIjeUrA9DclvzRZG6lLUboOBuoFCv05bsJHGFXqYTD41lq7McvXr_sfSQ4_UOusxejehN9FZzAToercxNlfBDfmtCSEhDeAzF97TOZ3clMaHETKmg4C5fUz97iV5NsAY8NXjfkZuP15-XXyeXd98-rKYX8-0aAoxk6grzTuJve5K3jdcaiklk4XQyAAQOa8L2XLsqpoVHHU2QRcwAAheiR7EGflw4E6p22QK2uhhVJM3G_A75cCof2-sWaml2yrOZC2zk5nw9pHg3beEIaq1Sz5_OSjetkxUe-ez6t1Bpb0LweNwbMGZ2kep9lGqhyiz-M3fQx2lf7LLAn4Q3JkRd_9BqfnV4uYA_Q2GE7Fm</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Green, William Ross</creator><creator>Chokshi, Ravi</creator><creator>Jabbour, Salma K.</creator><creator>DeLaney, Thomas F.</creator><creator>Mahmoud, Omar</creator><general>Wiley Subscription Services, Inc</general><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>7TO</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>201802</creationdate><title>Utilization pattern and survival outcomes of adjuvant therapies in high‐grade nonretroperitoneal abdominal soft tissue sarcoma: A population‐based study</title><author>Green, William Ross ; Chokshi, Ravi ; Jabbour, Salma K. ; DeLaney, Thomas F. ; Mahmoud, Omar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3723-8ec5c1b8edcb41d718c8880823ce0aaee1162891eb56021ec291c2afaa3153da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Neoplasms - mortality</topic><topic>Abdominal Neoplasms - pathology</topic><topic>Abdominal Neoplasms - radiotherapy</topic><topic>abdominal soft tissue sarcoma</topic><topic>adjuvant therapies</topic><topic>Adjuvant therapy</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant - statistics & numerical data</topic><topic>Data processing</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Grading</topic><topic>nonretroperitoneal sarcoma</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Proportional Hazards Models</topic><topic>Radiation therapy</topic><topic>Radiotherapy, Adjuvant - statistics & numerical data</topic><topic>Rare diseases</topic><topic>Sarcoma - drug therapy</topic><topic>Sarcoma - mortality</topic><topic>Sarcoma - pathology</topic><topic>Sarcoma - radiotherapy</topic><topic>Soft tissue sarcoma</topic><topic>Survival</topic><topic>survival outcomes</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Green, William Ross</creatorcontrib><creatorcontrib>Chokshi, Ravi</creatorcontrib><creatorcontrib>Jabbour, Salma K.</creatorcontrib><creatorcontrib>DeLaney, Thomas F.</creatorcontrib><creatorcontrib>Mahmoud, Omar</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Asia-Pacific journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Green, William Ross</au><au>Chokshi, Ravi</au><au>Jabbour, Salma K.</au><au>DeLaney, Thomas F.</au><au>Mahmoud, Omar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utilization pattern and survival outcomes of adjuvant therapies in high‐grade nonretroperitoneal abdominal soft tissue sarcoma: A population‐based study</atitle><jtitle>Asia-Pacific journal of clinical oncology</jtitle><addtitle>Asia Pac J Clin Oncol</addtitle><date>2018-02</date><risdate>2018</risdate><volume>14</volume><issue>1</issue><spage>101</spage><epage>113</epage><pages>101-113</pages><issn>1743-7555</issn><eissn>1743-7563</eissn><abstract>Background
Nonretroperitoneal abdominal soft tissue sarcoma (NRA‐STS) is a rare disease with limited data supporting its management. Our study aimed to reveal the utilization patterns of adjuvant therapy and its potential survival benefits using the National Cancer Data Base.
Materials
The analysis included patients with resected high‐grade NRA‐STS. Chi‐square analysis was used to evaluate distribution of patient and tumor‐related factors within treatment groups. The Kaplan–Meier and Cox proportional hazards model were utilized to evaluate overall survival according to treatment approach. Multivariate analysis was used to determine the impact of these factors on patients’ outcome. Matched propensity score analysis was implemented to control for imbalance of confounding variables.
Results
At median follow‐up of 49 months, 5‐year overall survival improved from 46% without adjuvant radiation therapy to 52% (P = 0.009) with radiotherapy delivery with a 30% reduction in hazard of death (95% confidence interval = 0.58–0.84). On multivariate analysis, age <50, tumor <8 cm, negative margins and radiotherapy delivery were significant predictors of improved survival. Chemotherapy was not associated with significant survival improvement (Hazard Ratios [HR]: 0.89, P = 0.28).
Conclusion
Adjuvant radiotherapy was associated with improved survival in high‐grade NRA‐STS. Chemotherapy was not associated with a survival improvement; however, further studies are needed to refine treatment strategies.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28464497</pmid><doi>10.1111/ajco.12683</doi><tpages>13</tpages></addata></record> |
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| subjects | Abdominal Neoplasms - mortality Abdominal Neoplasms - pathology Abdominal Neoplasms - radiotherapy abdominal soft tissue sarcoma adjuvant therapies Adjuvant therapy Age Factors Aged Chemotherapy Chemotherapy, Adjuvant - statistics & numerical data Data processing Databases, Factual Female Humans Kaplan-Meier Estimate Male Middle Aged Multivariate Analysis Neoplasm Grading nonretroperitoneal sarcoma Population studies Population-based studies Practice Patterns, Physicians' - statistics & numerical data Proportional Hazards Models Radiation therapy Radiotherapy, Adjuvant - statistics & numerical data Rare diseases Sarcoma - drug therapy Sarcoma - mortality Sarcoma - pathology Sarcoma - radiotherapy Soft tissue sarcoma Survival survival outcomes United States - epidemiology |
| title | Utilization pattern and survival outcomes of adjuvant therapies in high‐grade nonretroperitoneal abdominal soft tissue sarcoma: A population‐based study |
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