Biomaterial Database

Significance of intraoperative radiation therapy and high cumulative radiation doses in retroperitoneal soft tissue sarcoma. 2020

Franziska Willis, and Simon Schimmack, and Matthias Uhl, and Matthias F Haefner, and Gunhild Mechtersheimer, and Ulf Hinz, and Thomas Schmidt, and Jürgen Debus, and Stefan Fröhling, and Martin Schneider

Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.

In retroperitoneal soft tissue sarcoma (STS) local recurrence (LR) rates remain high despite more aggressive surgical approaches. Since wide resection margins cannot be achieved in all patients, application of intraoperative radiation therapy (IORT) has been frequently discussed. Still, the significance of IORT in multimodal treatment of retroperitoneal STS remains unclear. Patients undergoing resection of primary or recurrent retroperitoneal STS at the University of Heidelberg Department of General, Visceral and Transplantation Surgery were retrospectively analyzed. Univariate Kaplan-Meyer and multivariate Cox regression analyses were performed to identify predictors of LR-free survival and to investigate the impact of IORT and high cumulative radiation doses. Analyses with propensity-score matched subgroups for IORT and cumulative radiation dose were performed to control for selection bias. Subgroup analyses for patients with retroperitoneal liposarcoma were likewise performed. 272 patients were identified. Recurrent tumors, histology of dedifferentiated liposarcoma or unclassified sarcoma and microscopically incomplete resection were associated with decreased LR-free survival. In liposarcoma, only recurrent and dedifferentiated tumors were confirmed as poor prognostic factors concerning LR. IORT and cumulative radiation doses exceeding 60 Gy did not influence LR rates (estimated 5-year LR-free survival: IORT: 39%, non-IORT: 46%; p = 0.79). In this retrospective evaluation, additional application of IORT does not significantly influence oncological outcome in retroperitoneal soft tissue sarcoma. Randomized trials are needed to clarify the benefit of IORT.

UI	MeSH Term	Description	Entries
D007430	Intraoperative Care	Patient care procedures performed during the operation that are ancillary to the actual surgery. It includes monitoring, fluid therapy, medication, transfusion, anesthesia, radiography, and laboratory tests.	Care, Intraoperative
D007890	Leiomyosarcoma	A sarcoma containing large spindle cells of smooth muscle. Although it rarely occurs in soft tissue, it is common in the viscera. It is the most common soft tissue sarcoma of the gastrointestinal tract and uterus. The median age of patients is 60 years. (From Dorland, 27th ed; Holland et al., Cancer Medicine, 3d ed, p1865)	Leiomyosarcoma, Epithelioid,Leiomyosarcoma, Myxoid,Epithelioid Leiomyosarcoma,Epithelioid Leiomyosarcomas,Leiomyosarcomas,Leiomyosarcomas, Epithelioid,Leiomyosarcomas, Myxoid,Myxoid Leiomyosarcoma,Myxoid Leiomyosarcomas
D008080	Liposarcoma	A malignant tumor derived from primitive or embryonal lipoblastic cells. It may be composed of well-differentiated fat cells or may be dedifferentiated: myxoid (LIPOSARCOMA, MYXOID), round-celled, or pleomorphic, usually in association with a rich network of capillaries. Recurrences are common and dedifferentiated liposarcomas metastasize to the lungs or serosal surfaces. (From Dorland, 27th ed; Stedman, 25th ed)	Liposarcoma, Dedifferentiated,Liposarcoma, Pleomorphic,Atypical Lipomatous Tumor,Liposarcoma, Well Differentiated,Well Differentiated Liposarcoma,Atypical Lipomatous Tumors,Dedifferentiated Liposarcoma,Dedifferentiated Liposarcomas,Lipomatous Tumor, Atypical,Liposarcomas,Pleomorphic Liposarcoma,Pleomorphic Liposarcomas,Well Differentiated Liposarcomas
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009364	Neoplasm Recurrence, Local	The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site.	Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D011878	Radiotherapy	The use of IONIZING RADIATION to treat malignant NEOPLASMS and some benign conditions.	Radiotherapy, Targeted,Targeted Radiotherapy,Radiation Therapy,Radiation Therapy, Targeted,Radiation Treatment,Targeted Radiation Therapy,Radiation Therapies,Radiation Therapies, Targeted,Radiation Treatments,Radiotherapies,Radiotherapies, Targeted,Targeted Radiation Therapies,Targeted Radiotherapies,Therapies, Radiation,Therapies, Targeted Radiation,Therapy, Radiation,Therapy, Targeted Radiation,Treatment, Radiation
D011879	Radiotherapy Dosage	The total amount of radiation absorbed by tissues as a result of radiotherapy.	Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man