title: Adjuvant radiotherapy for extremity and trunk wall atypical lipomatous tumor/well-differentiated LPS (ALT/WD-LPS): a French Sarcoma Group (GSF-GETO) study.
abstract: BACKGROUND
  The role of adjuvant radiotherapy (RT) in the management of atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WD-LPS) remains controversial.
  
  
  METHODS
  Two hundred eighty-three patients with operable ALT/WD-LPS, no history of previous cancer, chemotherapy (CT) or RT, treated between 1984 and 2011 registered in the Conticabase database were included and described. Overall (OS), progression-free survival (PFS) and time to local relapse (TTLR) were evaluated from the time of first treatment.
  
  
  RESULTS
  Three of 20 centers enrolled 58% of the patients. Median age at diagnosis was 61 (range 25-94) years, 147 patients (52%) were males, 222 (78%) patients had their primary tumor located in an extremity while 36 (13%) and 25 (9%) had tumors involving the girdle and the trunk wall, respectively. The median size of primary tumors was 17 cm (range 2-48 cm). Adjuvant RT was given to 132 patients (47%). Patients who received adjuvant RT had larger tumors (P = 0.005), involving more often the distal limbs (P < 0.001). Use of adjuvant RT varied across centers and along the study period. Other characteristics were balanced between the two groups. Median follow-up was 61.7 months. None of the patients developed metastasis during follow-up. The 5-year local relapse-free survival rates were 98.3% versus 80.3% with and without adjuvant RT, respectively (P < 0.001). Once stratified on time period (before/after 2003), adjuvant RT, tumor site and margin status (R0 versus other) were independently associated with TTLR. No OS difference was observed (P = 0.105).
  
  
  CONCLUSIONS
  In this study, adjuvant RT following resection of ALT/WD-LPS was associated with a reduction of LR risk.
authors.affiliation: Department of Medical Oncology, Centre Léon Bérard, Lyon; INSERM UMR5286, Centre de Recherche en Cancérologie de Lyon, Université de Lyon, Lyon. Electronic address: cassierp@hotmail.com.
authors.forename: P A
authors.initials: PA
authors.lastname: Cassier
authors.affiliation: Department of Radiotherapy, Institut Bergonié, Bordeaux.
authors.forename: G
authors.initials: G
authors.lastname: Kantor
authors.affiliation: Department of Surgery, Institut Gustave Roussy, Villejuif.
authors.forename: S
authors.initials: S
authors.lastname: Bonvalot
authors.affiliation: Department of Biostatistics, Centre Léon Bérard, Lyon.
authors.forename: E
authors.initials: E
authors.lastname: Lavergne
authors.affiliation: Department of Surgery, Institut Bergonié, Bordeaux.
authors.forename: E
authors.initials: E
authors.lastname: Stoeckle
authors.affiliation: Department of Radiotherapy, Institut Gustave Roussy, Villejuif.
authors.forename: C
authors.initials: C
authors.lastname: Le Péchoux
authors.affiliation: Department of Surgery.
authors.forename: P
authors.initials: P
authors.lastname: Meeus
authors.affiliation: Department of Radiotherapy, Centre Léon Bérard, Lyon.
authors.forename: M-P
authors.initials: MP
authors.lastname: Sunyach
authors.affiliation: Department of Surgery, Hopital Edouard Herriot, Lyon.
authors.forename: G
authors.initials: G
authors.lastname: Vaz
authors.affiliation: Department of Pathology, Institut Bergonié, Bordeaux.
authors.forename: J-M
authors.initials: JM
authors.lastname: Coindre
authors.affiliation: Department of Medical Oncology, Centre Hospitalier Universitaire, Tours.
authors.forename: C
authors.initials: C
authors.lastname: Linassier
authors.affiliation: Department of Radiotherapy, Institut Curie, Paris.
authors.forename: A
authors.initials: A
authors.lastname: Labib
authors.affiliation: Department of Medical Oncology, Centre François Balcesse, Caen.
authors.forename: C
authors.initials: C
authors.lastname: Delcambre
authors.affiliation: Department of Medical Oncology, Centre Hospitalier Universitaire, Clermont Ferrand, France.
authors.forename: J-O
authors.initials: JO
authors.lastname: Bay
authors.affiliation: Department of Medical Oncology, Centre Hospitalier Universitaire, Lauzanne, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Leyvraz
authors.affiliation: Department of Radiotherapy, Hôpital La Timone, Marseille.
authors.forename: T
authors.initials: T
authors.lastname: Dubergé
authors.affiliation: Department of Radiotherapy, Hôpital Henri Mondor, Paris, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Lagrange
authors.affiliation: Department of Medical Oncology, Centre Léon Bérard, Lyon.
authors.forename: A
authors.initials: A
authors.lastname: Duret
authors.affiliation: Department of Medical Oncology, Centre Léon Bérard, Lyon; INSERM UMR5286, Centre de Recherche en Cancérologie de Lyon, Université de Lyon, Lyon.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Blay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008080:Liposarcoma / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D018714:Radiotherapy, Adjuvant
keywords: atypical lipomatous tumor; radiotherapy; surgery; well-differentiated liposarcoma