Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

Gewählte Publikation:

SHR Neuro Krebs Kardio Lipid Stoffw Microb

Posch, F; Partl, R; Döller, C; Riedl, JM; Smolle, M; Leitner, L; Bergovec, M; Liegl-Atzwanger, B; Stotz, M; Bezan, A; Gerger, A; Pichler, M; Kapp, KS; Stöger, H; Leithner, A; Szkandera, J.
Benefit of Adjuvant Radiotherapy for Local Control, Distant Metastasis, and Survival Outcomes in Patients with Localized Soft Tissue Sarcoma: Comparative Effectiveness Analysis of an Observational Cohort Study.
Ann Surg Oncol. 2018; 25(3):776-783 Doi: 10.1245/s10434-017-6080-3 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG


Führende Autor*innen der Med Uni Graz
Posch Florian
Szkandera Joanna
Co-Autor*innen der Med Uni Graz
Bergovec Marko
Döller Carmen
Gerger Armin
Kapp Karin S.
Leithner Andreas
Leitner Lukas
Liegl-Atzwanger Bernadette
Partl Richard
Pichler Martin
Riedl Jakob
Smolle Maria Anna
Stöger Herbert
Stotz Michael
Terbuch Angelika

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This study aimed to quantify the benefit of adjuvant radiotherapy (AXRT) for local control, distant metastasis, and long-term survival outcomes in patients with localized soft tissue sarcoma (STS). This single-center retrospective observational study enrolled 433 STS patients who underwent surgery with curative intent. An inverse probability of treatment-weighted (IPTW) analysis was implemented to account rigorously for imbalances in prognostic variables between the adjuvant treatment groups. During a median follow-up period of 5.5 years, the study observed 38 local recurrences (9%), 73 occurrences of distant metastasis (17%), 63 STS-related deaths (15%), and 57 deaths from other causes (13%). As expected, patients receiving AXRT (n = 258, 60%) were more likely to have high-grade G3 tumors (p < 0.0001) than patients not receiving AXRT. A crude analysis showed that AXRT was not associated with improved recurrence-free survival [hazard ratio (HR) 1.00; 95% confidence interval (CI) 0.72-1.38; p = 0.98]. However, after IPTW, AXRT was associated with a 38% relative reduction in the risk of recurrence or death (HR 0.62; 95% CI 0.39-1.00; p = 0.05). This benefit was driven by a strong reduction in the risk of local recurrence (HR 0.42; 95% CI 0.19-0.91; p = 0.03), whereas the relative risk of distant metastasis (HR 0.69; 95% CI 0.39-1.25; p = 0.22) and overall survival (HR 0.76; 95% CI 0.44-1.30; p = 0.32) were only nonsignificantly in favor of AXRT. An exploratory analysis showed an overall survival benefit of AXRT for patients with high-grade G3 tumors (HR 0.51; 95% CI 0.33-0.78; p = 0.002). However, this finding may have been attributable to residual confounding. In this observational cohort, AXRT was associated with a 58% reduction in the relative risk of local recurrence. No consistent association between AXRT and lower risks of distant metastasis or death was observed.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Aged -
Aged, 80 and over -
Female -
Follow-Up Studies -
Humans -
Male -
Middle Aged -
Neoplasm Invasiveness -
Neoplasm Metastasis -
Neoplasm Recurrence, Local - mortality
Neoplasm Recurrence, Local - pathology
Neoplasm Recurrence, Local - radiotherapy
Prognosis -
Radiotherapy, Adjuvant - mortality
Retrospective Studies -
Risk Factors -
Sarcoma - mortality
Sarcoma - radiotherapy
Sarcoma - secondary
Soft Tissue Neoplasms - mortality
Soft Tissue Neoplasms - pathology
Soft Tissue Neoplasms - radiotherapy
Survival Rate -
Young Adult -

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