Effect of radiation therapy on survival in surgically resected retroperitoneal sarcoma: a propensity score-adjusted SEER analysis.
BACKGROUND
Currently no prospective randomized trial has measured the efficacy of radiation therapy for resected retroperitoneal sarcomas (RPS). Our objective was to determine the effect of radiation therapy on disease-specific and overall survival between propensity score-matched surgically resected RPS patients using the Surveillance, Epidemiology, and End Results (SEER) database.


METHODS
The study population consisted of patients with histologically confirmed RPS who underwent surgical resection between 1988 and 2006. Exclusion criteria included multiple malignancies, distant metastasis, and unknown grade or stage. Cox modeling was used to determine covariate associations with disease-specific survival. Propensity score methods were used to perform survival analysis in patients who received radiation matched with patients who underwent surgery alone.


RESULTS
Prior to matching, there were 762 patients (558 surgery only, 204 surgery with radiation). Factors independently associated with radiation therapy were age (P = 0.037), geographic region (P = 0.041), grade (P = 0.047), stage (P = 0.003), and surgery type (P = 0.01). Cox modeling demonstrated that age, sex, grade, and stage were independently associated with survival. Propensity scoring (309 matched pairs) and survival analysis using Kaplan-Meier methods demonstrated no difference between propensity score-matched patients receiving radiation therapy and those who did not (P = 0.35).


CONCLUSIONS
At present, SEER patients with surgically resected RPS who received radiation therapy did not demonstrate survival benefit.
School of Medicine, Case Western Reserve University, Cleveland.
A H
AH
Choi
Case Comprehensive Cancer Center, Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, USA.
J S
JS
Barnholtz-Sloan
Case Comprehensive Cancer Center, Division of Surgical Oncology, Case Western Reserve University, Cleveland. Electronic address: julian.kim@uhhospitals.org.
J A
JA
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D057216:Propensity Score; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012186:Retroperitoneal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D018426:SEER Program; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D055815:Young Adult