title: The Use of Radiation Therapy in Well-Differentiated Soft Tissue Sarcoma of the Extremities: An NCDB Review.
abstract: Objective. This study investigated patterns of utilization of radiation therapy (RT) and correlated this with overall survival by assessing patients with well-differentiated soft tissue sarcoma of the extremity (STS-E) in the National Cancer Database (NCDB). Methods. All patients diagnosed with well-differentiated STS-E between 1998 and 2006 were identified in the NCDB. Patients were stratified by use of surgery alone versus use of adjuvant RT after surgery and analyzed using multivariate analysis, Kaplan-Meier analysis, and propensity matching. Results. 2113 patients with well-differentiated STS-E were identified in the NCDB for inclusion with a mean follow-up time of 74 months. 69% of patients were treated with surgery alone, while 26% were treated with surgery followed by adjuvant RT. Patients undergoing amputation were less likely to receive adjuvant RT. There was no difference in overall survival between patients with well-differentiated STS treated with surgery alone and those patients who received adjuvant RT. Conclusions. In the United States, adjuvant RT is being utilized in a quarter of patients being treated for well-differentiated STS-E. While the use of adjuvant RT may be viewed as a means to facilitate limb salvage, this large national database review confirms no survival benefit, regardless of tumor size or margin status.
authors.affiliation: School of Medicine, Duke University, Durham, NC 27710, USA.
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Lazarides
authors.affiliation: Department of Surgery, Division of Orthopedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Eward
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Speicher
authors.affiliation: Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei 10617, Taiwan.
authors.forename: Chun-Han
authors.initials: CH
authors.lastname: Hou
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Nussbaum
authors.affiliation: Department of Surgery, Division of Orthopedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Green
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Dan G
authors.initials: DG
authors.lastname: Blazer
authors.affiliation: Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Kirsch
authors.affiliation: Department of Surgery, Division of Orthopedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Brigman