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2007 | 79 | 4 | 297-304
Tytuł artykułu

Value of Combined Treatment of Retroperitoneal Sarcomas

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
The aim of the study was to determine treatment results in patients with retroperitoneal sarcomas, especially as respects the value of combined therapy.Material and methods. The study group included 37 patients with retroperitoneal sarcomas who underwent treatment at the Department of Oncological Surgery, Oncology Center in Gliwice during the period between 1992 and 2005. The study group included 25 women and 12 men, aged between 21 and 68 years (mean age - 56.2 years). Adjuvant therapy after the operation was performed in the case of 15 patients. Nine received adjuvant teleradiotherapy (RT) at an average dose of 47.5 Gy (one patient after a non-resective procedure). Four received intraoperative brachytherapy (BT) at a dose of 15.8 Gy in combination with postoperative teleradiotherapy at a dose of 39 Gy. One patient was subjected to intraoperative brachytherapy. One female patient received adjuvant chemotherapy (Iphosphamid + Adriamycin).Results. The cumulative five-year total survival period of the analysed group was 40.7% according to Kaplan-Meier's method. Twenty patients died and four were diagnosed with recurrence, while 13 continue to live without recurrence. The type of resection had a significant effect on total survival (p=0.013): the five-year survival after radical procedures was 52.1%. We observed no five-year survivals after nonradical procedures. In order to determine the efficacy of combined treatment, patients who underwent to radical therapy were divided into three groups: patients without adjuvant therapy (group 1: 22 patients, 62.9%), patients subjected to adjuvant RT and BT therapy after the primary operation (group II: 5 patients, 14.25%), and patients who underwent the above-mentioned treatments after surgery, due to recurrence (group III: 8 patients, 22.85%).The total five-year survival in group I was 34.8%, in group II, 80%, and in group III, 72.9%. These differences were statistically insignificant (p=0.440). These results were probably influenced by the small number of patients, considering particular groups.Conclusions. 1. The most important prognostic factor in the treatment of retroperitoneal sarcomas is surgical margine type surgical margin. 2. Adjuvant radiotherapy, especially in combination with intraoperative brachytherapy, seems to be a promising method for the management of retroperitoneal sarcomas, and improves treatment results. 3. Treatment of retroperitoneal sarcomas should be undertaken in specialized centers adequately prepared for combined therapy.
Wydawca

Rocznik
Tom
79
Numer
4
Strony
297-304
Opis fizyczny
Daty
wydano
2007-04-01
online
2007-10-17
Twórcy
  • Department of Oncological Surgery, M. Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice
  • Cancer Epidemiology Department, M. Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice
autor
  • Department of Oncological Surgery, M. Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice
  • Department of Radiotherapy, M. Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice
  • Department of Oncological Surgery, M. Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice
Bibliografia
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  • Herman K, Kusy T: Retroperitoneal sarcoma-the continued challenge for surgery and oncology. Surg Oncol 1998; 7: 77-81.
  • Jaques DP, Coit DG, Hajdu SI et al.: Management of primary and recurrent soft-tissue sarcoma of the retroperitoneum. Ann Surg 1990; 212: 51-59.
  • Jenkins MP, Alvarenga JC, Thomas JM: The management of retroperitoneal soft tissue sarcomas. Eur J Cancer 1996; 32A: 622-26.[PubMed]
  • Makela J, Kiviniemi H, Laitinen S: Prognostic factors predicting survival in the treatment of retroperitoneal sarcoma. Eur J Surg Oncol 2000; 26: 552-55.[Crossref][PubMed]
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  • Windham TC, Pisters PW: Retroperitoneal sarcomas. Cancer Control 2005; 12: 36-43.[PubMed]
  • Herman K, Gruchala A, Niezabitowski A i wsp.: Czynniki rokownicze w mięsakach zaotrzewnowych. Pol Przegl Chir 1999; 71: 32-35.
  • Lewis JJ, Leung D, Woodruff JM et al.: Retroperitoneal soft tissue sarcoma. Analysis of 500 patients treated and followed at a single institution. Ann Surg 1998; 228: 355-65.
  • Heslin JF, Lewis JJ, Nadler E et al.: Prognostic factors associated with long-term survival for retroperitoneal sarcomas: implications for management. J Clin Oncol 1997; 15: 2832-39.
  • Shibata D, Lewis JJ, Leung DH: Is there a role for incomplete resection in the management of retroperitoneal. J Am Coll Surg 2001; 193: 373-79.
  • Kilkenny JW III, Bland KI, Copeland EM III: Retroperitoneal sarcoma: the University of Florida experience. J Am Coll Surg 1996; 182: 329-39.
  • Sugarbaker P: Patterns of spread of recurrent intraabdominal sarcoma. Cancer Treat Res 1996; 82: 65-77.[PubMed]
  • Bobin JY, Al-Lawati T, Granero LE et al.: Surgical management of retroperitoneal sarcomas associated with external and intraoperative electron beam radiotherapy. Eur J Surg Oncol 2003; 29: 676-81.
  • Pisters PWT: Chemoradiation treatment strategies for localized sarcoma: conventional and investigational approaches. Semin Surg Oncol 1999; 17: 66-71.
  • Catton CN, Swallow CJ, O'Sullivan B et al.: A pilot study of external beam radiotherapy and pulsed dose rate brachytherapy for resectable retroperitoneal sarcomas. Radiother Oncol 1998; 47-54.
  • Dziewirski W, Rutkowski P, Nowecki Z et al.: Surgery combined with intraoperative brachytherapy in the treatment of retroperitoneal sarcomas. Ann Surg Oncol 2006; 13: 245-52.[Crossref]
  • Jones JJ, Catton CN, O'Sullivan B: Initial results of a trial of preoperative external-beam radiation therapy and postoperative brachytherapy for retroperitoneal sarcoma. Ann Surg Oncol 2002; 9: 346-54.[Crossref][PubMed]
  • Sindelar WF, Hoekstra HJ, Kinsella TJ: Surgical approaches and techniques in intraoperative radiotherapy for intra-abdominal, retroperitoneal and pelvic neoplasms. Surgery 1988; 103: 247-56.
  • Stoeckle E, Coindre JM, Bonvalot S et al.: French Federation of Cancer Centers Sarcoma Group: Prognostic factors in retroperitoneal sarcoma: a multivariate analysis of a series of 165 patients of the French Cancer Center Federation Sarcoma Group. Cancer 2001; 92: 359-68.
  • Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53: 457-81.[Crossref]
  • Singer S, Corson JM, Demetri GD i wsp.: Prognostic factors predictive of survival for truncal and retroperitoneal soft-tissue sarcoma. Ann Surg 1995; 221: 185-95.
  • Bonvalot S, Vanel D, Terrier P: Management of recurrent soft tissue sarcoma of the retroperitoneum. Bull Cancer 2004; 91: 845-52.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_v10035-007-0045-3
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