The addition of radiotherapy, either preoperatively or postoperatively, to surgery was associated with improved overall survival compared with surgery alone in patients with retroperitoneal sarcoma, a study published in Lancet Oncology has shown.1

Although the only multicenter, randomized trial in the United States investigating perioperative radiotherapy for retroperitoneal sarcoma was terminated due to recruitment challenges, the use of radiotherapy in this setting has increased in the last 10 years due to its established role in extremity sarcoma. Therefore, researchers sought to conduct a case-control study to compare overall survival for patients with retroperitoneal sarcoma who had surgery and preoperative radiotherapy or postoperative radiotherapy versus surgery alone.

For the study, researchers analyzed data from a total of 9068 adult patients with retroperitoneal sarcoma who were diagnosed between 2003 and 2011. Of those, 563 received preoperative radiotherapy, 2215 had postoperative radiotherapy, and 6290 had no radiotherapy.

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Results showed that at a median follow-up of 42 months for the preoperative radiotherapy group and 43 months for the no radiotherapy group, median overall survival was 110 months (95% CI, 75-not estimable) compared with 66 months (95% CI, 61-76), respectively.

Similarly, at a median follow-up of 54 months for patients who received postoperative radiotherapy and 47 months for patients who received no radiotherapy, median overall survival was 89 months (95% CI, 79-100) vs 64 months (95% CI, 55-69), respectively.

The findings demonstrated that patients who received radiotherapy before surgery had a 30% reduction in the risk of death (HR, 0.70; 95% CI, 0.59-0.82; P < .0001) and patients who underwent postoperative radiotherapy had a 22% reduction (HR, 0.78; 95% CI, 0.71-0.85; P < .0001) compared with surgery alone.

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This study, in combination with an ongoing EORTC trial, may provide additional support for the increasing use of radiation therapy in patients with retroperitoneal sarcoma undergoing surgical resection.                                       


  1. Nussbaum DP, Rushing CN, Lane WO, et al. Preoperative or postoperative radiotherapy versus surgery alone for retroperitoneal sarcoma: a case-control, propensity score-matched analysis of a nationwide clinical oncology database [published online ahead of print May 17, 2016]. Lancet Oncol. doi: 10.1016/S1470-2045(16)30050-X.