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Clinical Impact of External Beam Radiotherapy for Surgically Resected Primary Retroperitoneal Liposarcoma
Derek J Erstad1, Yi-Ju Chiang2, Russell G Witt2
1Department of Surgical Oncology, Baylor College of Medicine and the Michael E. DeBakey VA Medical Center, Houston, TX, USA. derstad@gmail.com.
Annals of Surgical Oncology
|September 17, 2022
Summary
Radiotherapy did not improve survival for patients with retroperitoneal liposarcoma. This real-world analysis found no overall survival benefit from neoadjuvant or adjuvant radiotherapy in patients undergoing surgical resection.
Area of Science:
- Surgical Oncology
- Radiation Oncology
- Medical Informatics
Background:
- The EORTC-62092 (STRASS) trial suggested potential benefit of neoadjuvant radiotherapy (RT) for well-differentiated liposarcoma.
- This study examines the real-world application and outcomes of RT in retroperitoneal liposarcoma management.
Purpose of the Study:
- To evaluate the association between radiotherapy (neoadjuvant and adjuvant) and overall survival (OS) in patients with primary retroperitoneal liposarcoma treated with surgical resection.
- To investigate real-world patterns of RT use and its impact on patient outcomes.
Main Methods:
- A retrospective analysis of the National Cancer Database (NCDB) from 2004-2017.
- Inclusion of patients with nonmetastatic, primary retroperitoneal liposarcoma treated with resection, with or without RT (n = 3911).
- Stratification by histology (well-differentiated [WD] and dedifferentiated [DD]) and propensity score (PS) matching for treatment group comparison.
Main Results:
- No association was found between RT and OS in either WD or DD liposarcoma cohorts.
- Subgroup analysis of neoadjuvant RT in WD liposarcoma (n = 208) showed no OS benefit but longer postoperative hospital stay.
- Neoadjuvant RT in DD liposarcoma (n = 290) was not associated with OS.
- RT use correlated with treatment at high-volume and academic/network facilities.
Conclusions:
- Radiotherapy is not associated with an overall survival benefit for primary retroperitoneal liposarcoma managed with surgical resection.
- Findings suggest RT may not be beneficial for improving survival outcomes in this patient population.
- Real-world data indicates RT utilization is concentrated in specialized treatment centers.
