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Is long-term survival possible after margin-positive resection of retroperitoneal sarcoma (RPS)? J Surg Oncol 2016 Jun;113(7):823-7

Date

04/10/2016

Pubmed ID

27060344

DOI

10.1002/jso.24232

Scopus ID

2-s2.0-84963686460   6 Citations

Abstract

BACKGROUND/OBJECTIVES: For various reasons, some patients undergo a gross margin positive resection (R2) leading to a dilemma in care. We hypothesized that there is a subset of patients who have long-term survival (LTS, ≥5 years) after R2 resection for retroperitoneal sarcoma (RPS).

METHODS: National Cancer Database data from 1998 to 2011 were reviewed to identify patients with RPS who had R2 resections. Logistic and Cox regression models were used to compare LTS with short-term survival.

RESULTS: Of 12,028 patients, R2 resection rate was 3.28% (4.9% in 1998; 2.5% in 2011). Median survival for RPS with R2 resection was 21 months versus 69 months for those with R0/R1 resections (P < 0.001). Of 272 patients with available survival, 24% (n = 64) survived ≥5 years with 64% alive at follow-up. LTS was most often seen in younger patients (<65 years) with well-differentiated liposarcoma. Chemotherapy appeared to improve survival in the first 3 postoperative years, but paradoxical effects were seen in LTS (Hazards Ratio [HR] 0.69, 95%CI: 0.50-0.95, P = 0.024) in first 3 years versus (HR 2.15, 95%CI: 1.21-3.81, P = 0.009).

CONCLUSION: Long-term survival is possible for a subset of patients after an R2 resection for RPS, especially with favorable histology characteristics. Benefits of chemotherapy in margin positive settings need to be investigated. J. Surg. Oncol. 2016;113:823-827. © 2016 Wiley Periodicals, Inc.

Author List

Klooster B, Rajeev R, Chrabaszcz S, Charlson J, Miura J, Bedi M, Gamblin TC, Johnston F, Turaga KK

Authors

Manpreet Bedi MD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin
John A. Charlson MD Associate Professor in the Medicine department at Medical College of Wisconsin
Thomas Clark Gamblin MD Chief, Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Antineoplastic Agents
Chemotherapy, Adjuvant
Databases, Factual
Female
Follow-Up Studies
Humans
Logistic Models
Male
Margins of Excision
Middle Aged
Prognosis
Retroperitoneal Neoplasms
Retrospective Studies
Sarcoma
Survival Analysis