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Excellent local control with preoperative radiation therapy, surgical resection, and intra‐operative electron radiation therapy for retroperitoneal sarcoma
Author(s) -
Stucky CheeChee H.,
Wasif Nabil,
Ashman Jonathan B.,
Pockaj Barbara A.,
Gunderson Leonard L.,
Gray Richard J.
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23576
Subject(s) - medicine , radiation therapy , surgery , sarcoma , intraoperative radiation therapy , surgical margin , disease control , radiology , resection , pathology , virology
Purpose To examine the value of surgical resection combined with preoperative external beam radiation therapy and intraoperative radiation therapy (Surg‐RT) for retroperitoneal sarcoma (RPS). Methods Review of 63 consecutive patients with RPS from 1996 to 2011. Results Thirty‐seven patients (59%) underwent Surg‐RT and 26 (41%) had surgery alone. 51% of tumors were high grade and 36% of patients had locally recurrent disease. Final margin status was: R0 73%, R1 16%, R2 6%, and unknown 5%. Of those with R0 resections, 67% received Surg‐RT. Median follow‐up was 45 months. The 5‐year local control rate was 89% for Surg‐RT patients and 46% for surgery alone patients ( P = 0.03). On multivariate analysis, Surg‐RT was the only variable associated with a lower risk of LR (HR 0.19; CI 0.05–0.69, P = 0.003). The actuarial 5‐year OS was 60% for patients receiving either Surg‐RT or surgery alone. Conclusions The combination of pre‐operative radiation, surgical resection, and intraoperative radiation produces excellent local disease control for RPS. Combination therapy was associated with improved local control but not with overall survival. J. Surg. Oncol. 2014 109:798–803 . © 2014 Wiley Periodicals, Inc.