Faculty Collaboration Database

Perioperative chemotherapy is not associated with improved survival in high-grade truncal sarcoma. J Surg Res 2018 Nov;231:248-256

Date

10/04/2018

Pubmed ID

30278937

DOI

10.1016/j.jss.2018.05.030

Scopus ID

2-s2.0-85048892540 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

BACKGROUND: The treatment benefit of perioperative chemotherapy (CTX) for truncal soft tissue sarcoma (STS) is not well established. This study evaluates the association of CTX with survival for patients with resected primary high-grade truncal STS.

MATERIALS AND METHODS: Adult patients with high-grade truncal STS who had curative-intent resection from 2000 to 2016 at seven U.S. institutions were evaluated retrospectively. Patients were stratified by receipt of CTX. Kaplan-Meier curves with log-rank tests were used to compare overall survival (OS) and recurrence-free survival. Logistic regression models were used to evaluate characteristics associated with OS.

RESULTS: Of patients with primary high-grade truncal STS, 235 underwent curative-intent resections. The most common histology was undifferentiated pleomorphic sarcoma and mean tumor size was 7.8 cm. Thirty percent of the patients received CTX (n = 70). Among patients receiving CTX, 34% (n = 24) had neoadjuvant CTX, 44% (n = 31) adjuvant CTX, and 21% (n = 15) had neoadjuvant and adjuvant CTX. Patients receiving CTX were more likely to receive radiation (51% versus 34%, P = 0.01), have deep tumors (86% versus 73%, P = 0.037) and solid organ invasion (14% versus 3%, P = 0.001). On univariate analysis, patients who received CTX had worse OS (P < 0.01) and a trend toward worse recurrence-free survival (P = 0.08). Margin status was the only variable associated with improved OS on multivariate analysis (odds ratio 4.36, 95% confidence interval 1.56, 12.13, P < 0.01).

CONCLUSIONS: In this multi-institutional retrospective analysis of resected high-grade truncal STS, receipt of perioperative CTX was not associated with improved OS, which may be related to selection bias. Microscopically negative margin status was the only independent factor associated with OS.

Author List

Yu PY, Beal EW, Hughes TM, Suarez-Kelly LP, Shelby RD, Ethun CG, Tran TB, Poultsides G, Charlson J, Gamblin TC, Tseng J, Roggin KK, Chouliaras K, Votanopoulos K, Krasnick BA, Fields RC, Pollock RE, Grignol V, Cardona K, Howard JH

Authors

John A. Charlson MD Associate Professor in the Medicine department at Medical College of Wisconsin
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin

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

Abdominal Neoplasms
Adult
Aged
Antineoplastic Agents
Chemotherapy, Adjuvant
Female
Humans
Male
Middle Aged
Perioperative Period
Retrospective Studies
Sarcoma
Thoracic Neoplasms
United States