Adequate Local Control in High-Risk Soft Tissue Sarcoma of the Extremity Treated with Surgery Alone at a Reference Centre: Should Radiotherapy Still be a Standard?

Annals of Surgical Oncology
Marco FioreAlessandro Gronchi

Abstract

Established practice for the management of soft tissue sarcoma (STS) of the extremity and trunk wall combines perioperative radiotherapy (RT) with limb-preserving surgery. The aim of this study was to explore whether high-quality surgery at high-volume centers may offer equivalent local control in selected cases, when RT needs to be avoided. All consecutive adult cases of primary, high-risk STSs treated in a high-volume reference center over a 12-year timeframe were included, and, on retrospective analysis, were divided into two groups. Group A received RT with surgery, and Group B received surgery alone. The primary endpoint was local recurrence-free survival (LRFS). Overall, 390 patients were included (318 in Group A and 72 in Group B), with a median follow-up of 53 months. The main reasons for avoiding RT were patient choice and technical considerations (vascular bypass or flap reconstruction). No difference in R0 resection was seen between the groups (79% vs. 70%; p = 0.18), but Group A had more G3 tumors (80.5% vs. 68%; p = 0.021). No difference in 5-year LRFS was evident (84% vs. 81%; p = 0.16). LRFS did not differ between patients with high-risk STSs receiving perioperative RT and those treated with surgery alone. The st...Continue Reading

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Citations

Jul 29, 2020·Annals of Surgical Oncology·Christina L RolandAlessandro Gronchi
Nov 14, 2018·Annals of Surgical Oncology·Marco Fiore, Alessandro Gronchi
Mar 30, 2019·Journal of Orthopaedic Surgery and Research·Jiaqi WuLibin Jin
Sep 28, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·R L Haas, A Gronchi
Jul 26, 2021·Annals of Oncology : Official Journal of the European Society for Medical Oncology·A GronchiUNKNOWN ESMO Guidelines Committee, EURACAN and GENTURIS. Electronic address: clinicalguidelines@esmo.org
Nov 26, 2021·Expert Review of Anticancer Therapy·Fabio TirottaAndrew J Hayes

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