Preoperative Radiotherapy in Patients With Primary Retroperitoneal Sarcoma: EORTC-62092 Trial (STRASS) Versus Off-trial (STREXIT) Results.

Autor:	Callegaro D; Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Raut CP; Department of Surgery, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA., Ajayi T; Department of Statistics, European Organisation for Research and Treatment of Cancer, Brussels, Belgium., Strauss D; Department of General Surgery, Royal Marsden NHS Foundation Trust, London, UK., Bonvalot S; Department of Surgery, Institute Curie, University of Paris, Paris, France., Ng D; Department of Surgical Oncology, Princess Margaret Cancer Center/Mount Sinai Hospital, Toronto, ON, Canada.; Department of Surgery, University of Toronto, Toronto, ON, Canada., Stoeckle E; Department of Surgery, Institut Bergonie, Bordeaux, France., Fairweather M; Department of Surgery, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA., Rutkowski P; Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland., van Houdt WJ; Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Gelderblom H; Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands., Sangalli C; Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Hayes A; Department of General Surgery, Royal Marsden NHS Foundation Trust, London, UK., Honoré C; Department of Surgical Oncology, Institut Gustave Roussy, Villejuif, France., Gladdy RA; Department of Surgical Oncology, Princess Margaret Cancer Center/Mount Sinai Hospital, Toronto, ON, Canada., Fau M; Department of Surgery, University of Toronto, Toronto, ON, Canada., Haas R; Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands.; Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands., Tzanis D; Department of Surgery, Institute Curie, University of Paris, Paris, France., Miah AB; Department of Radiation Oncology, Royal Marsden NHS Foundation Trust, and The Institute of Cancer Research, London, UK., Chung P; Department of Radiation Oncology, Princess Margaret Cancer Center/Mount Sinai Hospital, Toronto, ON, Canada.; Department of Surgery, University of Toronto, Toronto, ON, Canada., Baldini EH; Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA., Marreaud S; European Organisation for Research and Treatment of Cancer, Brussels, Belgium., Litiere S; Department of Statistics, European Organisation for Research and Treatment of Cancer, Brussels, Belgium., Swallow CJ; Department of Surgical Oncology, Princess Margaret Cancer Center/Mount Sinai Hospital, Toronto, ON, Canada., Gronchi A; Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2023 Jul 01; Vol. 278 (1), pp. 127-134. Date of Electronic Publication: 2022 Jul 14.
DOI:	10.1097/SLA.0000000000005492
Abstrakt:	Objective: The aim of the present study was to compare the effect of radiotherapy (RT) on abdominal recurrence-free survival (ARFS) in patients with primary retroperitoneal sarcoma treated in the EORTC-STBSG-62092 (STRASS) phase 3 randomized controlled trial (STRASS cohort) and off-trial (STREXIT cohort) and to pool STRASS and STREXIT data to test the hypothesis that RT improves ARFS in patients with liposarcoma. Background: The STRASS trial did not show any difference in ARFS between patients treated with preoperative radiotherapy+surgery (RT+S) versus surgery alone (S). Methods: All consecutive adult patients not enrolled in STRASS and underwent curative-intent surgery for a primary retroperitoneal sarcoma with or without preoperative RT between 2012 and 2017 (STRASS recruiting period) among ten STRASS-recruiting centres formed the STREXIT cohort. The effect of RT in STREXIT was explored with a propensity score (PS)-matching analysis. Primary endpoint was ARFS defined as macroscopically incomplete resection or abdominal recurrence or death of any cause, whichever occurred first. Results: STRASS included 266 patients, STREXIT included 831 patients (727 after excluding patients who received preoperative chemotherapy, 202 after 1:1 PS-matching). The effect of RT on ARFS in STRASS and 1:1 PS-matched STREXIT cohorts, overall and in patients with liposarcoma, was similar. In the pooled cohort analysis, RT administration was associated with better ARFS in patients with liposarcoma [N=321, hazard ratio (HR), 0.61; 95% confidence interval (CI), 0.42-0.89]. In particular, patients with well-differentiated liposarcoma and G1-2 dedifferentiated liposarcoma (G1-2 DDLPS, n=266) treated with RT+S had better ARFS (HR, 0.63; 95% CI, 0.40-0.97) while patients with G3 DDLPS and leiomyosarcoma had not. At the current follow-up, there was no association between RT and overall survival or distant metastases-free survival. Conclusions: In this study, preoperative RT was associated with better ARFS in patients with primary well-differentiated liposarcoma and G1-2 DDLPS. Competing Interests: The authors report no conflicts of interest. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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