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Effect of radiotherapy on local recurrence, distant metastasis and overall survival in 1200 extremity soft tissue sarcoma patients.:Retrospective analysis using IPTW-adjusted models

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اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • الموضوع:
      2023
    • Collection:
      University of Groningen research database
    • نبذة مختصرة :
      Background and purpose: Neoadjuvant (NRTX) and adjuvant radiotherapy (ARTX) reduce local recurrence (LR) risk in extremity soft tissue sarcoma (eSTS), yet their impact on distant metastasis (DM) and overall survival (OS) is less well defined. This study aimed at analysing the influence of NRTX/ARTX on all three endpoints using a retrospective, multicentre eSTS cohort. Materials and methods: 1200 patients (mean age: 60.7 ± 16.8 years; 44.4 % females) were retrospectively included, treated with limb sparing surgery and curative intent for localised, high grade (G2/3) eSTS. 194 (16.2 %), 790 (65.8 %), and 216 (18.0 %) patients had received NRTX, ARTX and no RTX, respectively. For the resulting three groups (no RTX vs. NRTX, no RTX vs. ARTX, NRTX vs. ARTX) Fine&Gray models for LR and DM, and Cox-regression models for OS were calculated, with IPTW-modelling adjusting for imbalances between groups. Results: In the IPTW-adjusted analysis, NRTX was associated with lower LR-risk in comparison to no RTX (SHR [subhazard ratio]: 0.236; p = 0.003), whilst no impact on DM-risk (p = 0.576) or OS (p = 1.000) was found. IPTW-weighted analysis for no RTX vs. ARTX revealed a significant positive association between ARTX and lower LR-risk (SHR: 0.479, p = 0.003), but again no impact on DM-risk (p = 0.363) or OS (p = 0.534). IPTW-weighted model for NRTX vs. ARTX showed significantly lower LR-risk for NRTX (SHR for ARTX: 3.433; p = 0.003) but no difference regarding DM-risk (p = 1.000) or OS (p = 0.639). Conclusion: NRTX and ARTX are associated with lower LR-risk, but do not seem to affect DM-risk or OS. NRTX may be favoured over ARTX as our results indicate better local control rates.
    • File Description:
      application/pdf
    • ISSN:
      0167-8140
      1879-0887
    • Relation:
      info:eu-repo/semantics/altIdentifier/pmid/37832791; info:eu-repo/semantics/altIdentifier/hdl/https://hdl.handle.net/11370/15008e39-1bfa-442f-a446-d7a1737025bf; info:eu-repo/semantics/altIdentifier/pissn/0167-8140; info:eu-repo/semantics/altIdentifier/eissn/1879-0887
    • الرقم المعرف:
      10.1016/j.radonc.2023.109944
    • الدخول الالكتروني :
      https://hdl.handle.net/11370/15008e39-1bfa-442f-a446-d7a1737025bf
      https://research.rug.nl/en/publications/15008e39-1bfa-442f-a446-d7a1737025bf
      https://doi.org/10.1016/j.radonc.2023.109944
      https://pure.rug.nl/ws/files/892738539/Effect_of_radiotherapy_on_local_recurrence_distant_metastasis_and_overall_survival_in_1200_extremity_soft_tissue_sarcoma_patients._Retrospective_analysis_using_IPTW-adjusted_models.pdf
      https://www.scopus.com/pages/publications/85174340892
    • Rights:
      info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/
    • الرقم المعرف:
      edsbas.F40BF990