Perioperative radiotherapy versus surgery alone for retroperitoneal sarcomas: a systematic review and meta-analysis

Radiol Oncol. 2020 Feb 29;54(1):14-21. doi: 10.2478/raon-2020-0012.

Abstract

Background There is no clear evidence on whether radiotherapy (RT) improves treatment result in patients with retroperitoneal sarcomas (RPS). Methods A systematic literature search was performed using PubMed, Scopus and CENTRAL databases. Data were retrieved from published comparatives studies in patients with RPS undergoing surgery alone or RT plus surgery. The primary endpoints were the 5-year OS and the median OS. The secondary endpoints were the recurrence-free survival (RFS) and the R0-resection rate. Continuous outcomes were calculated by means of weighted mean difference (WMD). Results Ten out of 374 articles were analyzed. The median OS and the 5-year survival were significantly increased in patients treated with RT and surgery, compared to patients treated with surgery alone (p < 0.00001, p < 0.001). Median RFS was significantly increased in patients treated with either preoperative (p < 0.001) or postoperative (p = 0.001) RT compared to patients that underwent surgery alone. Finally, median R0-resection rate was similar between the two groups (p = 0.56). Conclusion RT along with radical surgery could be the standard of care in at least a subgroup of patients with RPS.

Keywords: adjuvant radiotherapy; neoadjuvant radiotherapy; soft tissue sarcoma.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Combined Modality Therapy / methods
  • Combined Modality Therapy / mortality
  • Disease-Free Survival
  • Humans
  • Margins of Excision
  • Publication Bias
  • Retroperitoneal Neoplasms / mortality
  • Retroperitoneal Neoplasms / radiotherapy*
  • Retroperitoneal Neoplasms / surgery*
  • Sarcoma / mortality
  • Sarcoma / radiotherapy*
  • Sarcoma / surgery*
  • Time Factors