Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients
The aim of the present study is to assess the disease profile, outcome and prognostic factors in patients treated with surgery combined with radiotherapy (RT), with or without chemotherapy (CXT), for soft-tissue sarcoma (STS) in a multidisciplinary setting. One hundred and sixty-four patients with S...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2013-10-01
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| Series: | Rare Tumors |
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| Online Access: | http://www.pagepress.org/journals/index.php/rt/article/view/4799 |
| _version_ | 1828771918353793024 |
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| author | Ling Cai René-Olivier Mirimanoff Elyazid Mouhsine Louis Guillou Pierre-Francois Leyvraz Serge Leyvraz Beatrice Gay Oscar Matzinger Mahmut Ozsahin Abderrahim Zouhair |
| author_facet | Ling Cai René-Olivier Mirimanoff Elyazid Mouhsine Louis Guillou Pierre-Francois Leyvraz Serge Leyvraz Beatrice Gay Oscar Matzinger Mahmut Ozsahin Abderrahim Zouhair |
| author_sort | Ling Cai |
| collection | DOAJ |
| description | The aim of the present study is to assess the disease profile, outcome and prognostic factors in patients treated with surgery combined with radiotherapy (RT), with or without chemotherapy (CXT), for soft-tissue sarcoma (STS) in a multidisciplinary setting. One hundred and sixty-four patients with STS treated between 1980 and 2010 at the <em>Centre Hospitalier Universitaire Vaudois</em> were enrolled in this retrospective study. Seventy-six percent of patients underwent postoperative RT with (24%), or without (52%) CXT, 15% preoperative RT with (5%), or without (10%) CXT, surgery alone (7%), or RT alone (2%) with or without CXT. The median follow-up was 60 months (range 6-292). Local failure was observed in 18%, and distant failure in 21% of the patients. Overall survival (OS), disease-free survival (DFS), local control (LC) and distant metastases-free survival (DMFS) were 88%, 68%, 83%, and 79% at 5 years, and 80%, 56%, 76%, and 69% at 10 years, respectively. In univariate analyses, favorable prognostic factors for OS, DFS, and DMFS were tumor size 6 cm or less, World Health Organization (WHO)/Zubrod score 0, and stage 2 or less. Age and superficial tumors were favorable only for OS and DMFS respectively. STS involving the extremities had a better outcome regarding DFS and LC. Histological grade 2 or less was favorable for DFS, DMFS, and LC. Radical surgery was associated with better LC and DMFS. RT dose more than 60 Gy was favorable for OS, DFS, and LC. In multivariate analyses, independent factors were age for OS; tumor size for OS, DFS and DMFS; WHO/Zubrod score for OS, DFS and LC; hemoglobin level for DFS; site for DFS and LC; tumor depth for DMFS; histological grade for DFS and LC; surgical procedure for LC and DMFS; and RT dose for OS. This study confirms that in a multidisciplinary setting, STS have a fairly good prognosis. A number of prognostic and predictive factors, including the role of surgery combined with RT, were identified. Regarding RT, a dose of more than 60 Gy was associated with a better outcome, at the price of a higher toxicity. We could not demonstrate a superiority of preoperative RT over postoperative RT. |
| first_indexed | 2024-12-11T14:34:19Z |
| format | Article |
| id | doaj.art-7bc0e73db3a14bf6a75d70c181aff334 |
| institution | Directory Open Access Journal |
| issn | 2036-3605 2036-3613 |
| language | English |
| last_indexed | 2024-12-11T14:34:19Z |
| publishDate | 2013-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Rare Tumors |
| spelling | doaj.art-7bc0e73db3a14bf6a75d70c181aff3342022-12-22T01:02:16ZengSAGE PublishingRare Tumors2036-36052036-36132013-10-0154e55e5510.4081/rt.2013.e552647Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patientsLing Cai0René-Olivier Mirimanoff1Elyazid Mouhsine2Louis Guillou3Pierre-Francois Leyvraz4Serge Leyvraz5Beatrice Gay6Oscar Matzinger7Mahmut Ozsahin8Abderrahim Zouhair9Department of Radiation Oncology, Vaud University Hospital Center, LausanneDepartment of Radiation Oncology, Vaud University Hospital Center, LausanneDepartment of Orthopedic Surgery, Vaud University Hospital Center, LausanneDepartment of Pathology, Vaud University Hospital Center, LausanneDepartment of Orthopedic Surgery, Vaud University Hospital Center, LausanneDepartment of Medical Oncology, Vaud University Hospital Center, LausanneDepartment of Medical Oncology, Vaud University Hospital Center, LausanneDepartment of Radiation Oncology, Vaud University Hospital Center, LausanneDepartment of Radiation Oncology, Vaud University Hospital Center, LausanneDepartment of Radiation Oncology, Vaud University Hospital Center, LausanneThe aim of the present study is to assess the disease profile, outcome and prognostic factors in patients treated with surgery combined with radiotherapy (RT), with or without chemotherapy (CXT), for soft-tissue sarcoma (STS) in a multidisciplinary setting. One hundred and sixty-four patients with STS treated between 1980 and 2010 at the <em>Centre Hospitalier Universitaire Vaudois</em> were enrolled in this retrospective study. Seventy-six percent of patients underwent postoperative RT with (24%), or without (52%) CXT, 15% preoperative RT with (5%), or without (10%) CXT, surgery alone (7%), or RT alone (2%) with or without CXT. The median follow-up was 60 months (range 6-292). Local failure was observed in 18%, and distant failure in 21% of the patients. Overall survival (OS), disease-free survival (DFS), local control (LC) and distant metastases-free survival (DMFS) were 88%, 68%, 83%, and 79% at 5 years, and 80%, 56%, 76%, and 69% at 10 years, respectively. In univariate analyses, favorable prognostic factors for OS, DFS, and DMFS were tumor size 6 cm or less, World Health Organization (WHO)/Zubrod score 0, and stage 2 or less. Age and superficial tumors were favorable only for OS and DMFS respectively. STS involving the extremities had a better outcome regarding DFS and LC. Histological grade 2 or less was favorable for DFS, DMFS, and LC. Radical surgery was associated with better LC and DMFS. RT dose more than 60 Gy was favorable for OS, DFS, and LC. In multivariate analyses, independent factors were age for OS; tumor size for OS, DFS and DMFS; WHO/Zubrod score for OS, DFS and LC; hemoglobin level for DFS; site for DFS and LC; tumor depth for DMFS; histological grade for DFS and LC; surgical procedure for LC and DMFS; and RT dose for OS. This study confirms that in a multidisciplinary setting, STS have a fairly good prognosis. A number of prognostic and predictive factors, including the role of surgery combined with RT, were identified. Regarding RT, a dose of more than 60 Gy was associated with a better outcome, at the price of a higher toxicity. We could not demonstrate a superiority of preoperative RT over postoperative RT.http://www.pagepress.org/journals/index.php/rt/article/view/4799soft-tissue sarcoma, radiotherapy, preoperative, postoperative, complications, prognostic factors |
| spellingShingle | Ling Cai René-Olivier Mirimanoff Elyazid Mouhsine Louis Guillou Pierre-Francois Leyvraz Serge Leyvraz Beatrice Gay Oscar Matzinger Mahmut Ozsahin Abderrahim Zouhair Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients Rare Tumors soft-tissue sarcoma, radiotherapy, preoperative, postoperative, complications, prognostic factors |
| title | Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients |
| title_full | Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients |
| title_fullStr | Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients |
| title_full_unstemmed | Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients |
| title_short | Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients |
| title_sort | prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy a retrospective single center study on 164 patients |
| topic | soft-tissue sarcoma, radiotherapy, preoperative, postoperative, complications, prognostic factors |
| url | http://www.pagepress.org/journals/index.php/rt/article/view/4799 |
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