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10.1245/ASO.2006.05.035
Annals of Surgical Oncology 13:508-517 (2006)
© 2006 Society of Surgical Oncology
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Original Article

Long-Term Results of Two Prospective Trials of Preoperative External Beam Radiotherapy for Localized Intermediate- or High-Grade Retroperitoneal Soft Tissue Sarcoma

Timothy M. Pawlik, MD, MPH1, Peter W. T. Pisters, MD1, Lynn Mikula, MD2, Barry W. Feig, MD1, Kelly K. Hunt, MD1, Janice N. Cormier, MD, MPH1, Matthew T. Ballo, MD3, Charles N. Catton, MD4, Julia J. Jones, MD2, Brian O’Sullivan, MD4, Raphael E. Pollock, MD, PhD1 and Carol J. Swallow, MD, PhD2

1 Department of Surgical Oncology, Unit 444, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030
2 Department of Surgery, The University of Toronto, Princess Margaret Hospital and Mount Sinai Hospital, Room 1224, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5
3 Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030
4 Department of Radiation Oncology, The University of Toronto, Princess Margaret Hospital and Mount Sinai Hospital, Room 1224, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5

Correspondence: Address correspondence and reprint requests to: Peter W. T. Pisters, MD; E-mail: ppisters{at}mdanderson.org.

Background: The reported data on surgery plus radiotherapy for retroperitoneal soft tissue sarcomas (RPS) have been mostly from retrospective studies. We evaluated the long-term outcome of patients with operable RPS who were treated with protocol-based preoperative radiotherapy followed by complete surgical resection.

Methods: Data from two prospective trials that included preoperative radiotherapy and surgery for patients with radiographically resectable RPS were combined to define long-term relapse rates and survival.

Results: Seventy-two patients with intermediate- or high-grade RPS were treated with preoperative radiotherapy (median dose, 45 Gy; range, 18.0–50.4 Gy). Fifty-four patients (75%) had primary RPS, whereas 18 (25%) had recurrent disease. The median tumor size was 15.5 cm. Sixty-four patients completed the planned preoperative radiotherapy; 57 (89%) underwent laparotomy with curative intent, and 54 (95%) had a macroscopically complete (R0 or R1) resection. With a median follow-up of 40.3 months, 28 patients (52%) who received preoperative radiotherapy and underwent a macroscopically complete resection had recurrences. For the 54 patients who underwent R0 or R1 resection after preoperative radiotherapy, the 5-year local recurrence–free, disease-free, and overall survival rates were 60%, 46%, and 61%, respectively. The median overall survival has not been reached (>60 months).

Conclusions: Patients with intermediate- or high-grade RPS treated with preoperative radiotherapy plus complete resection had a median survival >60 months. This compares favorably to historical data for similar patients treated with surgery alone.

Key Words: Retroperitoneal sarcoma • Preoperative • Radiation • Resection • Recurrence • Survival






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