Surgery and postoperative radiation therapy in primary retroperitoneal sarcomas: Experience of the Cancer Center Alexis Vautrin

Autor: Fuks, David, Verhaeghe, Jean-Luc, Marchal , Frédéric, Guillemin, François, Beckendorf, Valérie, Peiffert, Didier, Leroux, Agnès, Rios, Maria, Troufléau, Philippe, Marchal, Christian
Přispěvatelé: D'Hallewin, Marie Ange, CHU Amiens-Picardie, Centre Alexis Vautrin (CAV), Centre de Recherche en Automatique de Nancy (CRAN), Université Henri Poincaré - Nancy 1 (UHP)-Institut National Polytechnique de Lorraine (INPL)-Centre National de la Recherche Scientifique (CNRS)
Jazyk: angličtina
Rok vydání: 2010
Předmět:
Zdroj: 15th Congress of the European Society of Surgical Oncology, ESSO 2010
15th Congress of the European Society of Surgical Oncology, ESSO 2010, Sep 2010, Bordeaux, France
Popis: s published in European Journal of Surgical Oncology (EJSO), Volume 36, Issue 9, Pages 793-932, September 2010; Background: Surgical resection remains the standard treatment for patients with re- sectable retroperitoneal sarcomas (RS). The aim of this study was to analyse the out- comes of patients with primary RS managed in a single Comprehensive Cancer Center. Materials and Methods: We analysed retrospectively data of 50 patients with primary RS who underwent curative-intent resection from 1975 to 2006. External beam radiotherapy (EBRT) and chemotherapy were delivered postoperatively to patients with risk of local re- currence. Demographics, surgical, pathological variables and chemo/radiation therapy were analyzed as prognosis factors and factors for the development of recurrence. Results: There were 22 males and 28 females with a mean age of 54`13 years. Median diameter of the tumour was 16`9 cm. Eleven (22%) patients had preop- erative biopsy. Surgery required visceral resections in 30 (60%) (nephrectomy n1⁄418). There were 16 leiomyosarcomas, 25 liposarcomas and 8 other sub-types of sarcomas. Twenty-one patients (42%) had clear surgical margins. Twenty-eight (56%) patients received adjuvant EBRT and doses ranged from 40 to 56 Gy (me- dian 45 Gy). Chemotherapy was delivered to 15 (30%) patients. At the end of the follow-up (median 55 months), 37 (74%) patients developed recurrence. Among patients who had EBRT, 9 (33%) patients developed recurrence within the planning target volume and 3 patients recurred outside of the radiation therapy fields. A poor tumour differentiation was the only risk factor of recurrence (p1⁄4.013) in uni- variate analysis. Adjuvant EBRT trends to increase the time of local recurrence from surgery (27 vs. 13 months, p1⁄4.05). The overall survival rates were 81%, 55% and 46% at 1, 3 and 5 years, respectively. At univariate analysis, clear surgical margins (p1⁄4.01), well tumour differentiation (p1⁄4.004) and postoperative EBRT (p1⁄4.02) had a significant favourable impact on overall survival. Conclusion: RS remains a clinical and therapeutic challenge to achieve complete re- section and to evaluate the real benefit of EBRT with the more recent techniques.
Databáze: OpenAIRE
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