title: Should adjuvant radiotherapy be administered in addition to front-line aggressive surgery (FAS) in patients with primary retroperitoneal sarcoma?
abstract: BACKGROUND
  As most patients with retroperitoneal sarcomas (RPS) die of local recurrence, front-line aggressive surgery (FAS) has been developed, and it seems to achieve better local control. The aim of this study was to evaluate conformal postoperative radiotherapy (PORT) in patients who had enlarged surgery.
  
  
  METHODS
  Between 1994 and 2008, 110 patients with primary RPS mainly operated by FAS were analysed. Sixty-two patients underwent surgery and no PORT (group S), and 48 received surgery and PORT (group S + R). The median age was 52. Most patients had 3D conformal PORT (81%) with a median dose of 50 Gy.
  
  
  RESULTS
  Comparing results at 5 years in the S and the S + R group, the cumulative rate of local failure was, respectively, 36% and 22% (NS); relapse-free survival was 47% and 60% (P = 0.02), and overall survival was, respectively, 77% and 71% (NS).
  
  
  CONCLUSIONS
  Even if patients with adjuvant PORT were at higher risk of recurrence, there was a trend for radiotherapy (RT) to decrease the local relapse rate and improve recurrence-free survival. This study confirms that adjuvant conformal RT should be evaluated in a randomized trial, the control arm being FAS. Adjuvant RT in the preoperative setting is being evaluated in an EORTC trial.
authors.affiliation: Department of Radiation Oncology, Institut Gustave-Roussy, Villejuif 94800, France. lepechoux@igr.fr
authors.forename: C
authors.initials: C
authors.lastname: Le Péchoux
authors.forename: E
authors.initials: E
authors.lastname: Musat
authors.forename: C
authors.initials: C
authors.lastname: Baey
authors.forename: H
authors.initials: H
authors.lastname: Al Mokhles
authors.forename: P
authors.initials: P
authors.lastname: Terrier
authors.forename: J
authors.initials: J
authors.lastname: Domont
authors.forename: A
authors.initials: A
authors.lastname: Le Cesne
authors.forename: A
authors.initials: A
authors.lastname: Laplanche
authors.forename: S
authors.initials: S
authors.lastname: Bonvalot
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality / Q000517:prevention & control*; D016016:Proportional Hazards Models; D011859:Radiography; D018714:Radiotherapy, Adjuvant; D012186:Retroperitoneal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D055815:Young Adult