title: The Benefit of Adjuvant Radiotherapy in High-grade Nonmetastatic Retroperitoneal Soft Tissue Sarcoma: A SEER Analysis.
abstract: Controversy persists on the use of adjuvant radiotherapy (RT) in patients with retroperitoneal sarcoma (RPS). High-grade disease is known to be associated with decreased local control and overall survival (OS). Because RT has proven beneficial for local control and OS in patients with high-grade extremity soft tissue sarcoma, we evaluated the efficacy of adjuvant RT in high-grade RPS.
  
  
  
  The Surveillance, Epidemiology, and End Results database was used to identify patients with pathology-confirmed RPS from 1973 to 2010. Clinical characteristics and outcomes were analyzed.
  
  
  
  Of 480 total patients, 144 (30.0%) received postoperative radiation. Patients who received adjuvant RT had improved median OS (36 mo) compared with those who did not (27 mo, hazard ratio [HR]=0.79, P=0.023). On multivariate analysis the use of adjuvant RT (HR=0.80; 95% confidence interval [CI], 0.65-0.98; P=0.029), male sex (HR=1.32; 95% CI, 1.10-1.59; P=0.003), age above 65 years (HR=1.38; 95% CI, 1.15-1.67; P=0.001), and increasing the Surveillance, Epidemiology, and End Results historical stage (HR=1.46; 95% CI, 1.21-1.76; P<0.001) were all prognostic factors for OS.
  
  
  
  In a large retrospective analysis, postoperative RT improved OS in high-grade RPS patients. As such, adjuvant RT should be strongly considered in all patients with high-grade RPS. The optimal timing of RT relative to surgery requires further study.
authors.affiliation: Departments of Radiation Oncology.
authors.forename: James E
authors.initials: JE
authors.lastname: Bates
authors.affiliation: Departments of Radiation Oncology.
authors.forename: Sughosh
authors.initials: S
authors.lastname: Dhakal
authors.affiliation: Departments of Radiation Oncology.
authors.forename: Ali
authors.initials: A
authors.lastname: Mazloom
authors.affiliation: Departments of Radiation Oncology.|Pediatrics, University of Rochester Medical Center, Rochester, NY.
authors.forename: Louis S
authors.initials: LS
authors.lastname: Constine
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D012186:Retroperitoneal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D012189:Retrospective Studies; D018426:SEER Program; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D016896:Treatment Outcome; D055815:Young Adult