Retroperitoneal Sarcomas - Perioperative Radiotherapy Versus Surgery Alone: Meta-Analysis

Postgraduate Thesis uoadl:2846892 101 Read counter

Unit:
Κατεύθυνση Χειρουργική Ογκολογία
Library of the School of Health Sciences
Deposit date:
2019-01-28
Year:
2019
Author:
Diamantis Alexandros
Supervisors info:
Γεώργιος Πολυμενέας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Θεοδόσιος Θεοδοσόπουλος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Γ. Τούτουζας, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Retroperitoneal Sarcomas - Perioperative Radiotherapy Versus Surgery Alone: Meta-Analysis
Languages:
English
Greek
Translated title:
Retroperitoneal Sarcomas - Perioperative Radiotherapy Versus Surgery Alone: Meta-Analysis
Summary:
BACKGROUND
Current literature is not clear whether radiotherapy, either preoperatively or postoperatively, reflects on a beneficial result in patients with retroperitoneal sarcomas (RPS). We attempt to investigate if perioperative radiotherapy plus surgery benefits the overall survival (OS) and the local control of the disease
AIM
To compare outcomes in patients with retroperitoneal sarcomas treated with radiotherapy plus surgery versus patients receiving surgery alone.
METHODS
A systematic literature search was performed using PubMed, Scopus and Cochrane Central Register Controlled Studies (CENTRAL) databases. Data were retrieved from all types of included published comparative studies in patients with retroperitoneal sarcoma undergoing surgery alone or radiotherapy, in adjuvant or neoadjuvant setting, plus surgery. The primary endpoints of the present study were the 5-year OS and the median OS. The secondary endpoints were the recurrence-free survival (RFS) and the R0 resection rate. Continuous outcomes were calculated by means of weighted mean difference (WMD).
RESULTS
Among the 374 articles in PubMed, Scopus and CENTRAL that were retrieved, ten articles were included in the quantitative synthesis. One prospective and 9 retrospective studies were included in this systematic review. The median OS was significantly increased in patients treated with radiotherapy compared to surgery alone (WMD: -18.94 [95% CI: -19.14, -18.74]; p < 0.00001). The 5-year survival was significantly increased in patients treated with either neoadjuvant or adjuvant therapy compared to surgery alone (WMD: 0.69 [95% CI: 0.62, 0.77]; p < 0.001). Median RFS was significantly increased in patients treated with either preoperative (WMD: 0.19 [95% CI: 0.11, 0.33]; p < 0.001) or postoperative (WMD: 0.49 [95% CI: 0.32, 0.75]; p =0.001) radiotherapy compared to surgery alone. Finally, median R0 resection rate was similar between the two groups in the neoadjuvant comparison (WMD: 1.21 [95% CI: 0.65, 2.25]; p = 0.56).
CONCLUSION
The effect of radiotherapy suggests that most of the patients with RPS should be assessed within a multidisciplinary sarcoma team to consider radiotherapy in their treatment strategy
Main subject category:
Health Sciences
Keywords:
Retroperitoneal sarcoma, Radiotherapy, Soft tissue sarcoma, Adjuvant radiotherapy, Neoadjuvant radiotherapy
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
23
Number of pages:
23

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