Definitive Local Therapy Is Associated with Improved Survival in Metastatic Soft Tissue Sarcomas

Cancers

RonnieA. Sebro¹  RobertJ.Wilson²  KristyL. Weber²  VishruthK. Reddy³  Sriram Venigalla³  JacobE. Shabason³  Varsha Jain³  RobertG. Maki⁴  DanielY. Lee⁵  Ashwin Amurthur⁵  Vivek Nimgaokar⁵ 

[1] Department of Biostatistics, Epidemiology and Bioinformatics, University of Pennsylvania, Philadelphia, PA 19104, USA;Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA;Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA;Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;

关键词: sarcoma;    radiation;    surgery;    local treatment;    survival;   

DOI  :  10.3390/cancers13050932

来源: DOAJ

【 摘 要 】

Background: Definitive local therapy is often utilized in patients with metastatic soft tissue sarcomas (STS) to reduce morbidity associated with local tumor progression. We hypothesize that it is associated with improved overall survival (OS). Methods: Patients with newly diagnosed metastatic STS treated with chemotherapy were identified from the National Cancer Database and dichotomized into cohorts: 1. definitive local therapy (defined as either definitive dose radiotherapy, definitive surgery, or surgery with perioperative radiotherapy) or 2. conservative therapy (defined as systemic therapy with or without palliative therapy). The association between definitive local therapy and OS, and factors associated with the receipt of definitive local therapy were assessed. Results: Total of 4180 patients were identified. Compared with the conservative therapy, receipt of any definitive local therapy was associated with improved OS (median 17.9 vs. 10.1 months). The survival benefit remained on multivariate analyses and propensity-score matched analyses, with a stepwise improvement with surgery and combined modality local therapy, specifically radiotherapy (HR: 0.77; p < 0.001), surgery (HR: 0.67; p < 0.001), and combined surgery and radiotherapy (HR: 0.42; p < 0.001). Conclusions: Analysis of a large national cancer registry of patients with metastatic STS suggests that chemotherapy plus definitive local therapy is associated with a significant survival benefit compared to the standard chemotherapy alone.

【 授权许可】

Unknown