Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Retroperitoneal liposarcoma: the role of adjuvant radiation therapy and the prognostic factors

  • Lee, Hong Seok (Department of Radiation Oncology, Sungkyunkwan University School of Medicine) ;
  • Yu, Jeong Il (Department of Radiation Oncology, Sungkyunkwan University School of Medicine) ;
  • Lim, Do Hoon (Department of Radiation Oncology, Sungkyunkwan University School of Medicine) ;
  • Kim, Sung Joo (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2016.07.10
  • Accepted : 2016.08.10
  • Published : 2016.09.30
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Abstract

Purpose: To evaluate the benefit of adjuvant radiation therapy (RT) for retroperitoneal liposarcoma (RPLS) following gross tumor removal. Materials and Methods: We reviewed 77 patients with primary RPLS surgically treated between January 2000 and December 2013. Cases with gross residual disease were excluded. Tumor grade was evaluated according to the French Federation of Cancer Centers Sarcoma Group (FNCLCC) system. Adjuvant RT was delivered to 32 patients (42%) using external beam RT alone. Median follow-up time was 36 months (range, 5 to 169). Results: Among 77 patients, 33 (43%) presented with well-differentiated, 31 (40%) with de-differentiated, 8 (10%) with myxoid/round and 4 (5%) with pleomorphic morphology. The RT group included less well-differentiated subtype than surgery group (28% vs. 53%). During follow up, 34 patients (44%) showed local recurrence. Local recurrence rate was lower in the RT group (38%) compared to the surgery group (49%). The 3-year local control rate (LC) was 55.6%, and the 3-year overall survival (OS) was 82.1%. Tumor histology and FNCLCC grade were significantly associated with local recurrence. There was no statistical significance of adding adjuvant RT in LC (p = 0.312). However, patients with tumor histology other than well-differentiated subtype showed marginally decreased local recurrence rate after adjuvant RT (3-year LC, RT 43.9% vs. no RT 35.3%; p = 0.087). Conclusion: RPLS patients receiving RT experienced less local recurrence. We suggest that the addition of adjuvant RT may be related to improvement of LCs, especially in patients with non-favorable histologic subtypes.

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References

  1. Mettlin C, Priore R, Rao U, Gamble D, Lane W, Murphy P. Results of the national soft-tissue sarcoma registry. J Surg Oncol 1982;19:224-7. https://doi.org/10.1002/jso.2930190410
  2. van Doorn RC, Gallee MP, Hart AA, et al. Resectable retroperitoneal soft tissue sarcomas: the effect of extent of resection and postoperative radiation therapy on local tumor control. Cancer 1994;73:637-42. https://doi.org/10.1002/1097-0142(19940201)73:3<637::AID-CNCR2820730322>3.0.CO;2-Y
  3. van de Rijn M, Fletcher JA. Genetics of soft tissue tumors. Annu Rev Pathol 2006;1:435-66. https://doi.org/10.1146/annurev.pathol.1.110304.100052
  4. Lee SY, Goh BK, Teo MC, et al. Retroperitoneal liposarcomas: the experience of a tertiary Asian center. World J Surg Oncol 2011;9:12. https://doi.org/10.1186/1477-7819-9-12
  5. Papanicolaou N, Yoder IC, Lee MJ. Primary retroperitoneal neoplasms: how close can we come in making the correct diagnosis. Urol Radiol 1992;14:221-8. https://doi.org/10.1007/BF02926936
  6. Jaques DP, Coit DG, Hajdu SI, Brennan MF. Management of primary and recurrent soft-tissue sarcoma of the retroperitoneum. Ann Surg 1990;212:51-9. https://doi.org/10.1097/00000658-199007000-00008
  7. Ballo MT, Zagars GK, Pollock RE, et al. Retroperitoneal soft tissue sarcoma: an analysis of radiation and surgical treatment. Int J Radiat Oncol Biol Phys 2007;67:158-63. https://doi.org/10.1016/j.ijrobp.2006.08.025
  8. Sampath S, Hitchcock YJ, Shrieve DC, Randall RL, Schultheiss TE, Wong JY. Radiotherapy and extent of surgical resection in retroperitoneal soft-tissue sarcoma: multi-institutional analysis of 261 patients. J Surg Oncol 2010;101:345-50.
  9. Lewis JJ, Leung D, Woodruff JM, Brennan MF. Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution. Ann Surg 1998;228:355-65. https://doi.org/10.1097/00000658-199809000-00008
  10. Raut CP, Pisters PW. Retroperitoneal sarcomas: combinedmodality treatment approaches. J Surg Oncol 2006;94:81-7. https://doi.org/10.1002/jso.20543
  11. Kinne DW, Chu FC, Huvos AG, Yagoda A, Fortner JG. Treatment of primary and recurrent retroperitoneal liposarcoma: twentyfive-year experience at Memorial Hospital. Cancer 1973;31:53-64. https://doi.org/10.1002/1097-0142(197301)31:1<53::AID-CNCR2820310108>3.0.CO;2-7
  12. van Dalen T, Plooij JM, van Coevorden F, et al. Long-term prognosis of primary retroperitoneal soft tissue sarcoma. Eur J Surg Oncol 2007;33:234-8. https://doi.org/10.1016/j.ejso.2006.09.020
  13. Bonvalot S, Rivoire M, Castaing M, et al. Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol 2009;27:31-7. https://doi.org/10.1200/JCO.2008.18.0802
  14. Gronchi A, Miceli R, Shurell E, et al. Outcome prediction in primary resected retroperitoneal soft tissue sarcoma: histology-specific overall survival and disease-free survival nomograms built on major sarcoma center data sets. J Clin Oncol 2013;31:1649-55. https://doi.org/10.1200/JCO.2012.44.3747
  15. Mullinax JE, Zager JS, Gonzalez RJ. Current diagnosis and management of retroperitoneal sarcoma. Cancer Control 2011;18:177-87. https://doi.org/10.1177/107327481101800305
  16. Pisters PW, Harrison LB, Leung DH, Woodruff JM, Casper ES, Brennan MF. Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol 1996;14:859-68. https://doi.org/10.1200/JCO.1996.14.3.859
  17. Yang JC, Chang AE, Baker AR, et al. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol 1998;16:197-203. https://doi.org/10.1200/JCO.1998.16.1.197
  18. Storm FK, Eilber FR, Mirra J, Morton DL. Retroperitoneal sarcomas: a reappraisal of treatment. J Surg Oncol 1981;17:1-7. https://doi.org/10.1002/jso.2930170102
  19. Strander H, Turesson I, Cavallin-Stahl E. A systematic overview of radiation therapy effects in soft tissue sarcomas. Acta Oncol 2003;42:516-31. https://doi.org/10.1080/02841860310014732
  20. Tuan J, Vitolo V, Vischioni B, et al. Radiation therapy for retroperitoneal sarcoma. Radiol Med 2014;119:790-802. https://doi.org/10.1007/s11547-013-0350-3
  21. Stoeckle E, Coindre JM, Bonvalot S, et al. Prognostic factors in retroperitoneal sarcoma: a multivariate analysis of a series of 165 patients of the French Cancer Center Federation Sarcoma Group. Cancer 2001;92:359-68. https://doi.org/10.1002/1097-0142(20010715)92:2<359::AID-CNCR1331>3.0.CO;2-Y
  22. Zhou Z, McDade TP, Simons JP, et al. Surgery and radiotherapy for retroperitoneal and abdominal sarcoma: both necessary and sufficient. Arch Surg 2010;145:426-31. https://doi.org/10.1001/archsurg.2010.70
  23. Nussbaum DP, Rushing CN, Lane WO, et al. Preoperative or postoperative radiotherapy versus surgery alone for retroperitoneal sarcoma: a case-control, propensity scorematched analysis of a nationwide clinical oncology database. Lancet Oncol 2016;17:966-75. https://doi.org/10.1016/S1470-2045(16)30050-X
  24. Singer S, Antonescu CR, Riedel E, Brennan MF. Histologic subtype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma. Ann Surg 2003;238:358-70.
  25. Ghadimi MP, Al-Zaid T, Madewell J, et al. Diagnosis, management, and outcome of patients with dedifferentiated liposarcoma systemic metastasis. Ann Surg Oncol 2011;18:3762-70. https://doi.org/10.1245/s10434-011-1794-0

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