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Radiotherapy associated with improved survival for high‐grade sarcoma of the extremity
Author(s) -
Kachare Swapnil D.,
Brinkley Jason,
Vohra Nasreen A.,
Zervos Emmanuel E.,
Wong Jan H.,
Fitzgerald Timothy L.
Publication year - 2015
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.23989
Subject(s) - medicine , radiation therapy , propensity score matching , sarcoma , univariate analysis , multivariate analysis , surgery , overall survival , stage (stratigraphy) , proportional hazards model , survival analysis , oncology , pathology , paleontology , biology
Background The impact of radiotherapy on local control in limb‐preserving surgery for high‐risk sarcoma has been well studied. However, the impact of the use and timing of radiation therapy on survival is unclear. Methods From 1988 to 2010, patients with Stage III extremity sarcoma were identified within the SEER registry and cohorts were created using propensity score matching between irradiated and non‐irradiated groups. Results A total of 2,606 patients were identified, with a median age of 59 years a majority were white (81%), male (54%), received radiotherapy (78%), and had lower extremity (80%) sarcomas. The most common subtype was fibrohistiocytic (29.8%). Patients treated with radiotherapy were younger (57.2 vs. 60.3 years) and differed in subtype compared to those untreated. The matched cohorts were better balanced for all factors. Radiation therapy was associated with a 5% 5‐year survival advantage on univariate analysis for both the unmatched ( P = 0.002) and matched cohorts ( P = 0.01). On multivariate analysis radiotherapy was associated with a 20% and 30% survival advantage for the matched and unmatched cohorts, respectively ( P ≤ 0.02). The timing of radiotherapy did not affect survival. Conclusions Radiotherapy, regardless of the timing, is associated with improved survival in high‐risk sarcoma. J. Surg. Oncol. 2015; 112:338–343 . © 2015 Wiley Periodicals, Inc.