Factors Associated with Improved Disease-Free Interval in Retroperitoneal Sarcoma
*Brooke C Bredbeck, *Lia Delaney, *Jodi Wilkowski, *Rashmi Chugh, *Lesly A Dossett, *Michael S Sabel, Christina V Angeles
University of Michigan, Ann Arbor, MI
Objective: To determine the initial disease-free interval and the factors associated with improved disease-free interval in patients with retroperitoneal and/or abdominal sarcomas who underwent surgical resection with curative intent. Design: Retrospective case series Setting: High-volume academic cancer center Patients: Patients diagnosed with retroperitoneal and/or abdominal sarcoma who were deemed surgically resectable with curative intent and had complete treatment history available. Data was collected between 1998-2014. 133 consecutive patients were included in the analysis. Interventions: N/A Main Outcome Measures: Initial disease-free interval (surgical date to first recurrence), and association of treatment, tumor, and patient factors with disease-free interval Results: Average age at diagnosis was 54.7 years (SD 18). Mean follow-up was 4.9 years (SD 4.6) and mean initial disease-free interval was 3.1 years (SD 3.9), with 61% of patients having documented recurrence. 80% of sarcomas were retroperitoneal. The most common histologic diagnoses were leiomyosarcoma (24%) and liposarcoma (47%), of which 61% were dedifferentiated. 13% of patients underwent neoadjuvant radiation therapy. Regarding margin status, 51% of resections were R0 and 45% were R1. On multivariate logistic regression, factors associated with increased disease-free interval were R0 resection (p=0.004), neoadjuvant radiation therapy (p<0.001), and well-differentiated tumor (p=0.002). Neoadjuvant chemotherapy and age at diagnosis were not significant. Conclusions: At a single high-volume center, most patients experienced a recurrence after resection of their retroperitoneal/abdominal sarcoma. However, several factors influenced length of disease-free interval, including margin status and treatment with neoadjuvant radiation. The benefit of neoadjuvant radiation in retroperitoneal sarcoma continues to be questioned. There is a need for translational research to identify which patients may benefit from radiation therapy.
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