Excellent local control with preoperative radiation therapy, surgical resection, and intra-operative electron radiation therapy for retroperitoneal sarcoma

Chee Chee H Stucky, Nabil Wasif, Jonathan B. Ashman, Barbara A Pockaj, Leonard L. Gunderson, Richard J. Gray

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)798-803
Number of pages6
JournalJournal of Surgical Oncology
Volume109
Issue number8
DOIs
StatePublished - 2014

Fingerprint

Sarcoma
Radiotherapy
Electrons
Radiation
Multivariate Analysis
Survival
Neoplasms

Keywords

  • intraoperative radiation
  • radiation therapy
  • retroperitoneal
  • sarcoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Excellent local control with preoperative radiation therapy, surgical resection, and intra-operative electron radiation therapy for retroperitoneal sarcoma. / Stucky, Chee Chee H; Wasif, Nabil; Ashman, Jonathan B.; Pockaj, Barbara A; Gunderson, Leonard L.; Gray, Richard J.

In: Journal of Surgical Oncology, Vol. 109, No. 8, 2014, p. 798-803.

Research output: Contribution to journalArticle

@article{386260539212477fbcbcd3198773674f,
title = "Excellent local control with preoperative radiation therapy, surgical resection, and intra-operative electron radiation therapy for retroperitoneal sarcoma",
abstract = "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.",
keywords = "intraoperative radiation, radiation therapy, retroperitoneal, sarcoma",
author = "Stucky, {Chee Chee H} and Nabil Wasif and Ashman, {Jonathan B.} and Pockaj, {Barbara A} and Gunderson, {Leonard L.} and Gray, {Richard J.}",
year = "2014",
doi = "10.1002/jso.23576",
language = "English (US)",
volume = "109",
pages = "798--803",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "8",

}

TY - JOUR

T1 - Excellent local control with preoperative radiation therapy, surgical resection, and intra-operative electron radiation therapy for retroperitoneal sarcoma

AU - Stucky, Chee Chee H

AU - Wasif, Nabil

AU - Ashman, Jonathan B.

AU - Pockaj, Barbara A

AU - Gunderson, Leonard L.

AU - Gray, Richard J.

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

KW - intraoperative radiation

KW - radiation therapy

KW - retroperitoneal

KW - sarcoma

UR - http://www.scopus.com/inward/record.url?scp=84900532012&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84900532012&partnerID=8YFLogxK

U2 - 10.1002/jso.23576

DO - 10.1002/jso.23576

M3 - Article

VL - 109

SP - 798

EP - 803

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 8

ER -