TY - JOUR
T1 - Predictors of disease-free and overall survival in retroperitoneal sarcomas
T2 - A modern 16-year multi-institutional study from the United States sarcoma collaboration (USSC)
AU - Schwartz, Patrick B.
AU - Vande Walle, Kara
AU - Winslow, Emily R.
AU - Ethun, Cecilia G.
AU - Tran, Thuy B.
AU - Poultsides, George
AU - Tseng, Jennifer
AU - Roggin, Kevin
AU - Grignol, Valerie
AU - Howard, John Harrison
AU - Krasnick, Bradley A.
AU - Fields, Ryan C.
AU - Mogal, Harveshp
AU - Clarke, Callisia N.
AU - Senehi, Rebecca
AU - Votanopoulos, Konstantinos
AU - Cardona, Kenneth
AU - Abbott, Daniel E.
N1 - Funding Information:
.is research was not funded by any specific grant, but was supported by Daniel Abbott, MD, as a part of his employment. We would like to thank Dr. Jesse Davidson, MD, from Washington University who assisted in the preliminary data gathering and abstract generation.
Publisher Copyright:
© 2019 Patrick B. Schwartz et al.
PY - 2019
Y1 - 2019
N2 - Background. Retroperitoneal sarcomas (RPS) comprise approximately 15% of all soft-tissue sarcomas and frequently associated with significant morbidity and as little as 30% 5-year survival. Here, we provide a large, contemporary, and multi-institutional experience to determine which tumor, patient, and treatment characteristics are associated with long-term outcomes in RPS. Methods. 571 patients with primary RPS were identified from the United States Sarcoma Collaboration (USSC). RPS patients who underwent resection from January 2000 to April 2016 were included with patient, tumor, and treatment-specific variables investigated as independent predictors of survival. Survival analyses for disease-free and overall survival were conducted using Kaplan-Meier and Cox proportional hazards model methods. Results. The study cohort was 55% female, with a median age of 58.9 years (IQR: 48.6-70.0). The most common tumor histiotypes were liposarcoma (34%) and leiomyosarcoma (28%). Median follow-up was 30.6 months (IQR: 11.2-60.4). Median disease-free survival was 35.3 months (95% CI: 27.6-43.0), with multivariate predictors of poorer disease-free survival including higher grade tumors, nodal-positive disease, and multivisceral resection. Median overall survival was 81.6 months (95% CI: 66.3-96.8). Multivariate predictors of shorter overall survival included higher grade tumors, nodal-positive and multifocal disease, systemic chemotherapy, and grossly positive margins (R2) following resection. Conclusions. The strongest predictors of disease-free and overall survival are tumor-specific characteristics, while surgical factors are less impactful. Nonsurgical therapies are not associated with improved outcomes despite persistent interest and utilization. Complete macroscopic resection (R0/R1) remains a persistent potentially modifiable risk factor associated with improved overall survival in patients with retroperitoneal sarcomas.
AB - Background. Retroperitoneal sarcomas (RPS) comprise approximately 15% of all soft-tissue sarcomas and frequently associated with significant morbidity and as little as 30% 5-year survival. Here, we provide a large, contemporary, and multi-institutional experience to determine which tumor, patient, and treatment characteristics are associated with long-term outcomes in RPS. Methods. 571 patients with primary RPS were identified from the United States Sarcoma Collaboration (USSC). RPS patients who underwent resection from January 2000 to April 2016 were included with patient, tumor, and treatment-specific variables investigated as independent predictors of survival. Survival analyses for disease-free and overall survival were conducted using Kaplan-Meier and Cox proportional hazards model methods. Results. The study cohort was 55% female, with a median age of 58.9 years (IQR: 48.6-70.0). The most common tumor histiotypes were liposarcoma (34%) and leiomyosarcoma (28%). Median follow-up was 30.6 months (IQR: 11.2-60.4). Median disease-free survival was 35.3 months (95% CI: 27.6-43.0), with multivariate predictors of poorer disease-free survival including higher grade tumors, nodal-positive disease, and multivisceral resection. Median overall survival was 81.6 months (95% CI: 66.3-96.8). Multivariate predictors of shorter overall survival included higher grade tumors, nodal-positive and multifocal disease, systemic chemotherapy, and grossly positive margins (R2) following resection. Conclusions. The strongest predictors of disease-free and overall survival are tumor-specific characteristics, while surgical factors are less impactful. Nonsurgical therapies are not associated with improved outcomes despite persistent interest and utilization. Complete macroscopic resection (R0/R1) remains a persistent potentially modifiable risk factor associated with improved overall survival in patients with retroperitoneal sarcomas.
UR - http://www.scopus.com/inward/record.url?scp=85067822528&partnerID=8YFLogxK
U2 - 10.1155/2019/5395131
DO - 10.1155/2019/5395131
M3 - Article
C2 - 31281208
AN - SCOPUS:85067822528
SN - 1357-714X
VL - 2019
JO - Sarcoma
JF - Sarcoma
M1 - 5395131
ER -