title: Adjuvant radiation therapy for resectable retroperitoneal soft tissue sarcoma: the University of Florida experience.
abstract: BACKGROUND
  In the management of retroperitoneal sarcomas it is necessary to achieve local control to ensure survival. The role of adjuvant radiation therapy (RT), either pre- or postoperative, remains controversial.
  
  
  METHODS
  Outcomes for 40 patients with retroperitoneal sarcoma treated with surgery and postoperative RT (n = 25) or preoperative RT (n = 15) were analyzed for variables prognostic for local control, survival, and associated complications.
  
  
  RESULTS
  Patterns of failure for patients treated by resection and postoperative RT were local (n = 4), local and distant (n = 3), and distant (n = 3). The failure patterns for preoperative RT cases were local (n = 2), local and distant (n = 2); and distant (n = 4). Median time to local recurrence in the postoperative and preoperative RT series were 1 year and 2.5 years respectively. The margin status was predictive for local control (P = 0.0065) and survival (P = 0.0012), regardless of treatment sequence. Absolute 5-year survival was 12% with positive margins versus 69% if negative. Histologic grade was indicative of the risk for distant metastasis (low grade 8% vs high grade 64%; P = 0.1373), and significantly predicted 5-year absolute survival (low grade 77% vs high grade 34%; P = 0.0267). Postoperative RT was associated with significant complications (infection, hemorrhage, and bowel obstruction--2 cases each).
  
  
  CONCLUSIONS
  Compared with the surgery-alone series, adjuvant RT appears to improve the probability of local control. Preoperative RT may be the preferred sequence potentially to improve tumor resectability and local-regional control with less risk of complications than with postoperative RT.
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida 32610-0385, USA. zlotera@ufl.edu
authors.forename: Robert A
authors.initials: RA
authors.lastname: Zlotecki
authors.forename: Teri S
authors.initials: TS
authors.lastname: Katz
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Morris
authors.forename: D Scott
authors.initials: DS
authors.lastname: Lind
authors.forename: Steven N
authors.initials: SN
authors.lastname: Hochwald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005431:Florida; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D012186:Retroperitoneal Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012509:Sarcoma / Q000532:radiotherapy* / Q000601:surgery; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D007496:Iridium Radioisotopes