Retroperitoneal sarcomas: patterns of care in advanced stages, prognostic factors and focus on main histological subtypes: a multicenter analysis of the French Sarcoma Group
| Autor: | S. Bonvalot, J.-Y. Blay, Jacques-Olivier Bay, P. Terrier, N. Isambert, Maud Toulmonde, Emmanuelle Bompas, C. Le Pechoux, Christine Chevreau, Nicolas Penel, C. Delcambre-Lair, Dominique Ranchère-Vince, A. Lecesne, O. Riou, Esma Saada, Sophie Piperno-Neumann, I.L. Ray-Coquard, V. Brouste, Agnès Neuville, Antoine Italiano, E. Stoeckle |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Leiomyosarcoma Male medicine.medical_specialty Palliative care Internal medicine Antineoplastic Combined Chemotherapy Protocols Medicine Humans Anthracyclines Retroperitoneal Neoplasms Stage (cooking) Neoplasm Metastasis Survival rate Retrospective Studies Performance status business.industry Palliative Care Retrospective cohort study Sarcoma Hematology Liposarcoma Original Articles medicine.disease Prognosis Chemotherapy regimen Surgery Survival Rate Treatment Outcome Oncology Disease Progression Female France business Delivery of Health Care Progressive disease |
| Zdroj: | Annals of oncology : official journal of the European Society for Medical Oncology. 25(3) |
| ISSN: | 1569-8041 |
| Popis: | Background Retroperitoneal sarcomas (RPS) are heterogeneous. Advanced stages include unresectable locoregional (LR) disease, abdominal sarcomatosis and distant metastasis. There is no available report assessing palliative chemotherapy in advanced RPS. This study analyzes management and outcome in a large cohort of patients with advanced RPS, considering main histological subtypes separately. Patients and methods We conducted a retrospective analysis of adult patients diagnosed with a RPS between 1 January 1988 and 31 December 2008 across 12 centers of the French Sarcoma Group. All cases were centrally reviewed by an expert pathologist. Results Five-hundred eighty-six patients were included, 299 patients received palliative chemotherapy, with a median of two lines (range 0–8). Fifty patients underwent palliative surgery. Two hundred fifty-five patients (85%) were assessable for response after first line of chemotherapy. Among them, 69 patients (27%) had progressive disease, 145 (57%) had stable disease, 37 (14.5%) had partial response and 4 (1.5%) complete response. Median time from first line of palliative chemotherapy to progression was 5.9 months [4.9–7.3] and median overall survival (OS), 15.8 months [13–18]. In multivariate analysis, prognosis factors independently associated with poor OS were male gender, performance status (PS) >1 and grade >1. There was no difference according to stage of disease. Palliative surgery did not appear to add any survival benefit. Conclusion These results emphasize the scarcity of available options for RPS in the advanced setting and the urgent need to develop new strategies. Patients with good PS should be included in clinical trials and best supportive care should be considered in those with poor PS. |
| Databáze: | OpenAIRE |
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