• Postoperative radiotherapy in...

Treffer: Postoperative radiotherapy in patients with R0 resection of soft tissue sarcoma: results from the European sarcoma CONTICABASE analysis.

Title:
Postoperative radiotherapy in patients with R0 resection of soft tissue sarcoma: results from the European sarcoma CONTICABASE analysis.
Authors:
Sunyach MP; Department of Radiotherapy, Léon Bérard Cancer Center, Lyon 69673, France., Lusque A; Department of Biostatistics, University Institute of Cancer Toulouse-Oncopôle, Toulouse 311 00, France., Le Péchoux C; Department of Radiotherapy, Gustave Roussy, Villejuif 94800, France., Levy A; Department of Radiotherapy, Gustave Roussy, Villejuif 94800, France., Sargos P; Department of Radiotherapy, Bergonié Institute, Bordeaux 33076, France., Helfre S; Department of Radiotherapy, Curie Institute, Paris 75005, France., Thariat J; Department of Radiotherapy, Antoine Lacassagne Cancer Center, Nice 06100, France.; Department of Radiotherapy, François Baclesse Cancer Center, Caen 14000, France., Moureau Zabotto L; Department of Radiotherapy, Paoli Calmettes Institute, Marseille 13009, France.; Radiotherapy Center PAYS d'AIX, Aix-en-Provence 13100, France., Lerouge D; Department of Radiotherapy, François Baclesse Cancer Center, Caen 14000, France., Llacer C; Department of Radiotherapy, Cancer Institute Val d'Aurelle, Montpellier 34090, France., Mervoyer A; Department of Radiotherapy, René Gauducheau Cancer Institute, Nantes 44800, France.; Department of Radiotherapy, Institut de cancérologie de l'Ouest, Centre Paul Papin, Angers 44805, France., Vogin G; Department of Radiotherapy, Lorraine Cancer Institute, Vandoeuvre-les-Nancy 54519, France.; Department of Radiation Oncology du Grand-Duché du Luxembourg, Esch sur Alzette 4240, Luxembourg., Chevreau C; Department of Medical Oncology, University Institute of Cancer Toulouse-Oncopôle, Toulouse 31100, France., Ducimetière F; Equipe EMS, Centre Léon Bérard, Lyon 69673, France., Blay JY; Department of Medical Oncology, Centre Léon Bérard, Lyon, France.; Claude Bernard University Lyon 1, Lyon 69100, France.; Headquarters, Unicancer, Paris 75013, France., Delannes M; Department of Radiotherapy, University institute of Cancer Toulouse-Oncopôle, Toulouse 31100, France., Ducassou A; Department of Radiotherapy, University institute of Cancer Toulouse-Oncopôle, Toulouse 31100, France.
Source:
The British journal of radiology [Br J Radiol] 2025 Sep 01; Vol. 98 (1173), pp. 1409-1418.
Publication Type:
Journal Article; Multicenter Study
Language:
English
Journal Info:
Publisher: Oxford University Press Country of Publication: England NLM ID: 0373125 Publication Model: Print Cited Medium: Internet ISSN: 1748-880X (Electronic) Linking ISSN: 00071285 NLM ISO Abbreviation: Br J Radiol Subsets: MEDLINE
Imprint Name(s):
Publication: January 2024- : [Oxford] : Oxford University Press
Original Publication: London, British Institute of Radiology.
MeSH Terms:
Postoperative Care* , Sarcoma*/diagnostic imaging , Sarcoma*/radiotherapy , Sarcoma*/surgery , Databases as Topic*, Radiotherapy ; Europe ; Humans ; Male ; Female ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Retrospective Studies ; Databases, Factual ; Disease-Free Survival ; Treatment Outcome
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Contributed Indexing:
Keywords: disease-free survival; local control; overall survival; reference center; soft tissue sarcoma; surgery; tumour margin size
Entry Date(s):
Date Created: 20250703 Date Completed: 20250911 Latest Revision: 20250911
Update Code:
20250912
PubMed Central ID:
PMC12377468
DOI:
10.1093/bjr/tqaf068
PMID:
40609017
Database:
MEDLINE

Weitere Informationen

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.
(© The Author(s) 2025. Published by Oxford University Press on behalf of the British Institute of Radiology.)