Intraoperative Electron Radiation Therapy in Retroperitoneal Sarcoma

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Retroperitoneal soft-tissue sarcomas are rare and often present challenges in treatment due to their location and potential for recurrence.
• Multimodal treatment approaches involving surgery and radiation are frequently employed to improve outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of a combined treatment strategy using surgery, intraoperative radiation therapy (IORT), and external beam radiation therapy (EBRT) for retroperitoneal soft-tissue sarcomas.

Main Methods:

• A retrospective review of 156 patients with primary or recurrent retroperitoneal soft-tissue sarcoma treated with surgery, IORT, and often EBRT.
• Analysis of local control (LC), overall survival (OS), and complications in relation to treatment variables and patient characteristics.

Main Results:

• The 5-year local control and overall survival rates were 50% and 56%, respectively. Factors significantly impacting LC included disease status, grade, resection margin, and addition of EBRT.
• Multivariate analysis identified disease status, grade, and resection margin as independent prognostic factors for OS. Perioperative mortality was 1%, with 34% experiencing major complications.

Conclusions:

• Combined modality treatment with surgery, IORT, and EBRT is a feasible approach for retroperitoneal soft-tissue sarcomas, yielding acceptable local control and survival rates.
• Incomplete resection and recurrent disease are associated with significantly poorer outcomes, underscoring the importance of achieving complete resection during primary treatment to prevent local recurrence.