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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]
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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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Abstract:

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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