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A Mouse Model of Incompletely Resected Soft Tissue Sarcoma for Testing Neoadjuvant Therapies
Published on: July 28, 2020
Postoperative radiotherapy in patients with R0 resection of soft tissue sarcoma: results from the European sarcoma
Marie-Pierre Sunyach1, Amélie Lusque2, Cécile Le Péchoux3
1Department of Radiotherapy, Léon Bérard Cancer Center, Lyon 69673, France.
Objectives:
We aim to report the outcomes of soft tissue sarcoma (STS) patients with surgical R0 margin size (large: ≥5 mm or close: ≥1 to <5 mm) tumour, treated or not with postoperative radiotherapy (RT).
Methods:
The Connective Tissue Cancer Network database CONTICABASE collected data from adult patients diagnosed from 1999 to 2016 for histologically-proven locally advanced STS of trunk or limbs, with surgical R0 margin size (large: ≥5 mm; close: ≥1 to <5 mm), who did not receive neoadjuvant/adjuvant chemotherapy. A propensity score matching analysis was performed to account for potential treatment selection biases. We reported local control (LC), disease-free survival (DFS), overall survival (OS), RT impact in subgroup analyses, and performed multivariable analyses adjusted for classical prognostic factors.
Results:
Among 738 patients with STS eligible from 11 sites, 524 patients had R0 surgical margins, either treated with postoperative RT (N = 374, 71.4%), or not (N = 150). Besides similar characteristics regarding sex, age, margin size, and preoperative MRI assessment, more tumour localizations in lower limbs (62.8% vs 46%), larger tumours (≥5 cm) (68.4% vs 46%), deeper tumours (75.9% vs 56%), and more grade ≥3 tumours (50.4% vs 32.7%) were reported in patients having received adjuvant RT. The median follow-up was 74.7 [95% CI 71.8-83.0] months, 10-year-LC, -DFS, and -OS were 77.5% [95% CI 71.2-82.6], 51.0% [45.1-56.7], and 69.6% [63.7-74.6], respectively. The multivariable analysis showed that patients with older age and larger tumours are more at risk in terms of LC, DFS, and OS. Preoperative MRI assessment (HR 0.43, 95% CI 0.22-0.83; P = .012) and RT (HR 0.27, 95% CI 0.15-0.49; P < .001) were significantly associated with better LC. However, RT did not impact OS. Subgroup analyses showed that RT also benefit to grade 1 and 2 tumours.
Conclusion:
This series shows that adjuvant RT improved LC in all patients with STS with surgical R0 resection.
Advances In Knowledge:
This series did not identify subgroups in whom RT can be deleted.
