Annals of surgical oncology · 2025
Refining the Contemporary Management of Primary Retroperitoneal Soft Tissue Sarcoma: Outcome Improvement Over Time at a Single Institution.
СтатьяНазвание и аннотация: Перевод в очереди
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Fiore Marco, Barretta Francesco, Figura Costanza, Radaelli Stefano, Colombo Chiara, Baia Marco, Borghi Alessandra, Di Blasi Elena, Collini Paola, Vanzulli Andrea, Buonomenna Ciriaco, Greco Francesca G, Vigorito Raffaella, Morosi Carlo, Sangalli Claudia, Allajbej Albina, Sanfilippo Roberta, Salvatore Daniela, Pasquali Sandro, Miceli Rosalba, Casali Paolo G, Stacchiotti Silvia, Callegaro Dario, Gronchi Alessandro
Аннотация
BACKGROUND: This study aimed to investigate outcome for patients affected by primary retroperitoneal sarcomas (RPS) treated over time at a single large referral institution.
METHODS: The study included all consecutive patients with primary, localized, adult-type soft tissue sarcoma of the retroperitoneum observed and treated at the authors' institution from January 2002 to December 2021. The primary endpoint was overall survival (OS). The secondary endpoints were crude cumulative incidence (CCI) of local recurrence (LR) and distant metastases (DM), and post-recurrence OS. Based on the date of primary surgery, the patients were divided in two groups (2002-2011 and 2012-2021).
RESULTS: The study identified 872 patients: 244 treated between 2002 and 2011 (early cohort) and 628 treated between 2012 and 2021 (recent cohort). The median follow-up period was 77.1 months (interquartile range [IQR], 41.7-115.4): 136.7 months (IQR, 118.1-166.4 months) for the early cohort and 59.5 months (IQR, 34.1-88.9 months) for the recent cohort. At the multivariable analysis, the patients in the recent cohort had significantly better OS. The early cohort had a 5 year OS of 61.7% (95% CI, 55.9-68.2%) and a 10 year OS of 47.7% (95% CI, 41.7-54.6%), whereas the recent cohort had a 5 year OS of 78.8% (95% CI, 75.1-82.6%) and a 10 year OS of 64.0% (95% CI, 57.8-70.8%). The recent cohort had fewer distant metastases (hazard ratio [HR], 1.50; 95% CI, 1.06-2.11; p = 0.022) and a similar rate of local recurrences (HR, 1.31; 95% CI, 0.97-1.76; p = 0.080). The 30 month post-recurrence OS was 41.9% (95% CI, 34.5-50.9%) in the early cohort and 65.9% (95% CI, 59.5-72.9%) in the recent cohort (p < 0.001).
CONCLUSIONS: Management of RPS in the recent years has resulted in prolonged OS. These findings establish new standards for historical comparisons of emerging strategies.
METHODS: The study included all consecutive patients with primary, localized, adult-type soft tissue sarcoma of the retroperitoneum observed and treated at the authors' institution from January 2002 to December 2021. The primary endpoint was overall survival (OS). The secondary endpoints were crude cumulative incidence (CCI) of local recurrence (LR) and distant metastases (DM), and post-recurrence OS. Based on the date of primary surgery, the patients were divided in two groups (2002-2011 and 2012-2021).
RESULTS: The study identified 872 patients: 244 treated between 2002 and 2011 (early cohort) and 628 treated between 2012 and 2021 (recent cohort). The median follow-up period was 77.1 months (interquartile range [IQR], 41.7-115.4): 136.7 months (IQR, 118.1-166.4 months) for the early cohort and 59.5 months (IQR, 34.1-88.9 months) for the recent cohort. At the multivariable analysis, the patients in the recent cohort had significantly better OS. The early cohort had a 5 year OS of 61.7% (95% CI, 55.9-68.2%) and a 10 year OS of 47.7% (95% CI, 41.7-54.6%), whereas the recent cohort had a 5 year OS of 78.8% (95% CI, 75.1-82.6%) and a 10 year OS of 64.0% (95% CI, 57.8-70.8%). The recent cohort had fewer distant metastases (hazard ratio [HR], 1.50; 95% CI, 1.06-2.11; p = 0.022) and a similar rate of local recurrences (HR, 1.31; 95% CI, 0.97-1.76; p = 0.080). The 30 month post-recurrence OS was 41.9% (95% CI, 34.5-50.9%) in the early cohort and 65.9% (95% CI, 59.5-72.9%) in the recent cohort (p < 0.001).
CONCLUSIONS: Management of RPS in the recent years has resulted in prolonged OS. These findings establish new standards for historical comparisons of emerging strategies.