Preoperative Radiotherapy in Patients With Primary Retroperitoneal Sarcoma: EORTC-62092 Trial (STRASS) Versus Off-trial (STREXIT) Results

Dario Callegaro; Chandrajit P. Raut; Taiwo Ajayi; Dirk Strauss; Sylvie Bonvalot; Deanna Ng; Eberhard Stoeckle; Mark Fairweather; Piotr Rutkowski; Winan J. Van Houdt; Hans Gelderblom; Claudia Sangalli; Andrew Hayes; Charles Honoré; Rebecca A. Gladdy; Magali Fau; Rick Haas; Dimitri Tzanis; Aisha B. Miah; Peter Chung; Elizabeth H. Baldini; Sandrine Marreaud; Saskia Litiere; Carol J. Swallow; Alessandro Gronchi

doi:10.1097/SLA.0000000000005492

Preoperative Radiotherapy in Patients With Primary Retroperitoneal Sarcoma: EORTC-62092 Trial (STRASS) Versus Off-trial (STREXIT) Results

Dario Callegaro, Chandrajit P. Raut, Taiwo Ajayi, Dirk Strauss, Sylvie Bonvalot, Deanna Ng, Eberhard Stoeckle, Mark Fairweather, Piotr Rutkowski, Winan J. Van Houdt, Hans Gelderblom, Claudia Sangalli, Andrew Hayes, Charles Honoré, Rebecca A. Gladdy, Magali Fau, Rick Haas, Dimitri Tzanis, Aisha B. Miah, Peter ChungElizabeth H. Baldini, Sandrine Marreaud, Saskia Litiere, Carol J. Swallow, Alessandro Gronchi

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Résumé

Objective: The aim of the present study was to compare the effect of radiotherapy (RT) on abdominal recurrence-free survival (ARFS) in patients with primary retroperitoneal sarcoma treated in the EORTC-STBSG-62092 (STRASS) phase 3 randomized controlled trial (STRASS cohort) and off-trial (STREXIT cohort) and to pool STRASS and STREXIT data to test the hypothesis that RT improves ARFS in patients with liposarcoma. Background: The STRASS trial did not show any difference in ARFS between patients treated with preoperative radiotherapy+surgery (RT+S) versus surgery alone (S). Methods: All consecutive adult patients not enrolled in STRASS and underwent curative-intent surgery for a primary retroperitoneal sarcoma with or without preoperative RT between 2012 and 2017 (STRASS recruiting period) among ten STRASS-recruiting centres formed the STREXIT cohort. The effect of RT in STREXIT was explored with a propensity score (PS)-matching analysis. Primary endpoint was ARFS defined as macroscopically incomplete resection or abdominal recurrence or death of any cause, whichever occurred first. Results: STRASS included 266 patients, STREXIT included 831 patients (727 after excluding patients who received preoperative chemotherapy, 202 after 1:1 PS-matching). The effect of RT on ARFS in STRASS and 1:1 PS-matched STREXIT cohorts, overall and in patients with liposarcoma, was similar. In the pooled cohort analysis, RT administration was associated with better ARFS in patients with liposarcoma [N=321, hazard ratio (HR), 0.61; 95% confidence interval (CI), 0.42-0.89]. In particular, patients with well-differentiated liposarcoma and G1-2 dedifferentiated liposarcoma (G1-2 DDLPS, n=266) treated with RT+S had better ARFS (HR, 0.63; 95% CI, 0.40-0.97) while patients with G3 DDLPS and leiomyosarcoma had not. At the current follow-up, there was no association between RT and overall survival or distant metastases-free survival. Conclusions: In this study, preoperative RT was associated with better ARFS in patients with primary well-differentiated liposarcoma and G1-2 DDLPS.

langue originale	Anglais
Pages (de - à)	127-134
Nombre de pages	8
journal	Annals of Surgery
Volume	278
Numéro de publication	1
Les DOIs	https://doi.org/10.1097/SLA.0000000000005492
état	Publié - 1 juil. 2023

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10.1097/SLA.0000000000005492

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Callegaro, D., Raut, C. P., Ajayi, T., Strauss, D., Bonvalot, S., Ng, D., Stoeckle, E., Fairweather, M., Rutkowski, P., Van Houdt, W. J., Gelderblom, H., Sangalli, C., Hayes, A., Honoré, C., Gladdy, R. A., Fau, M., Haas, R., Tzanis, D., Miah, A. B., ... Gronchi, A. (2023). Preoperative Radiotherapy in Patients With Primary Retroperitoneal Sarcoma: EORTC-62092 Trial (STRASS) Versus Off-trial (STREXIT) Results. Annals of Surgery, 278(1), 127-134. https://doi.org/10.1097/SLA.0000000000005492

@article{80cbb365c7574dbda69c929fc0c126b8,

title = "Preoperative Radiotherapy in Patients With Primary Retroperitoneal Sarcoma: EORTC-62092 Trial (STRASS) Versus Off-trial (STREXIT) Results",

abstract = "Objective: The aim of the present study was to compare the effect of radiotherapy (RT) on abdominal recurrence-free survival (ARFS) in patients with primary retroperitoneal sarcoma treated in the EORTC-STBSG-62092 (STRASS) phase 3 randomized controlled trial (STRASS cohort) and off-trial (STREXIT cohort) and to pool STRASS and STREXIT data to test the hypothesis that RT improves ARFS in patients with liposarcoma. Background: The STRASS trial did not show any difference in ARFS between patients treated with preoperative radiotherapy+surgery (RT+S) versus surgery alone (S). Methods: All consecutive adult patients not enrolled in STRASS and underwent curative-intent surgery for a primary retroperitoneal sarcoma with or without preoperative RT between 2012 and 2017 (STRASS recruiting period) among ten STRASS-recruiting centres formed the STREXIT cohort. The effect of RT in STREXIT was explored with a propensity score (PS)-matching analysis. Primary endpoint was ARFS defined as macroscopically incomplete resection or abdominal recurrence or death of any cause, whichever occurred first. Results: STRASS included 266 patients, STREXIT included 831 patients (727 after excluding patients who received preoperative chemotherapy, 202 after 1:1 PS-matching). The effect of RT on ARFS in STRASS and 1:1 PS-matched STREXIT cohorts, overall and in patients with liposarcoma, was similar. In the pooled cohort analysis, RT administration was associated with better ARFS in patients with liposarcoma [N=321, hazard ratio (HR), 0.61; 95% confidence interval (CI), 0.42-0.89]. In particular, patients with well-differentiated liposarcoma and G1-2 dedifferentiated liposarcoma (G1-2 DDLPS, n=266) treated with RT+S had better ARFS (HR, 0.63; 95% CI, 0.40-0.97) while patients with G3 DDLPS and leiomyosarcoma had not. At the current follow-up, there was no association between RT and overall survival or distant metastases-free survival. Conclusions: In this study, preoperative RT was associated with better ARFS in patients with primary well-differentiated liposarcoma and G1-2 DDLPS.",

keywords = "STRASS, STREXIT, radiotherapy, recurrence, retroperitoneal sarcoma, sarcoma, survival",

author = "Dario Callegaro and Raut, {Chandrajit P.} and Taiwo Ajayi and Dirk Strauss and Sylvie Bonvalot and Deanna Ng and Eberhard Stoeckle and Mark Fairweather and Piotr Rutkowski and {Van Houdt}, {Winan J.} and Hans Gelderblom and Claudia Sangalli and Andrew Hayes and Charles Honor{\'e} and Gladdy, {Rebecca A.} and Magali Fau and Rick Haas and Dimitri Tzanis and Miah, {Aisha B.} and Peter Chung and Baldini, {Elizabeth H.} and Sandrine Marreaud and Saskia Litiere and Swallow, {Carol J.} and Alessandro Gronchi",

year = "2023",

month = jul,

day = "1",

doi = "10.1097/SLA.0000000000005492",

language = "English",

volume = "278",

pages = "127--134",

journal = "Annals of Surgery",

issn = "0003-4932",

number = "1",

}

Callegaro, D, Raut, CP, Ajayi, T, Strauss, D, Bonvalot, S, Ng, D, Stoeckle, E, Fairweather, M, Rutkowski, P, Van Houdt, WJ, Gelderblom, H, Sangalli, C, Hayes, A, Honoré, C, Gladdy, RA, Fau, M, Haas, R, Tzanis, D, Miah, AB, Chung, P, Baldini, EH, Marreaud, S, Litiere, S, Swallow, CJ & Gronchi, A 2023, 'Preoperative Radiotherapy in Patients With Primary Retroperitoneal Sarcoma: EORTC-62092 Trial (STRASS) Versus Off-trial (STREXIT) Results', Annals of Surgery, VOL. 278, Numéro 1, p. 127-134. https://doi.org/10.1097/SLA.0000000000005492

TY - JOUR

T1 - Preoperative Radiotherapy in Patients With Primary Retroperitoneal Sarcoma

T2 - EORTC-62092 Trial (STRASS) Versus Off-trial (STREXIT) Results

AU - Callegaro, Dario

AU - Raut, Chandrajit P.

AU - Ajayi, Taiwo

AU - Strauss, Dirk

AU - Bonvalot, Sylvie

AU - Ng, Deanna

AU - Stoeckle, Eberhard

AU - Fairweather, Mark

AU - Rutkowski, Piotr

AU - Van Houdt, Winan J.

AU - Gelderblom, Hans

AU - Sangalli, Claudia

AU - Hayes, Andrew

AU - Honoré, Charles

AU - Gladdy, Rebecca A.

AU - Fau, Magali

AU - Haas, Rick

AU - Tzanis, Dimitri

AU - Miah, Aisha B.

AU - Chung, Peter

AU - Baldini, Elizabeth H.

AU - Marreaud, Sandrine

AU - Litiere, Saskia

AU - Swallow, Carol J.

AU - Gronchi, Alessandro

PY - 2023/7/1

Y1 - 2023/7/1

N2 - Objective: The aim of the present study was to compare the effect of radiotherapy (RT) on abdominal recurrence-free survival (ARFS) in patients with primary retroperitoneal sarcoma treated in the EORTC-STBSG-62092 (STRASS) phase 3 randomized controlled trial (STRASS cohort) and off-trial (STREXIT cohort) and to pool STRASS and STREXIT data to test the hypothesis that RT improves ARFS in patients with liposarcoma. Background: The STRASS trial did not show any difference in ARFS between patients treated with preoperative radiotherapy+surgery (RT+S) versus surgery alone (S). Methods: All consecutive adult patients not enrolled in STRASS and underwent curative-intent surgery for a primary retroperitoneal sarcoma with or without preoperative RT between 2012 and 2017 (STRASS recruiting period) among ten STRASS-recruiting centres formed the STREXIT cohort. The effect of RT in STREXIT was explored with a propensity score (PS)-matching analysis. Primary endpoint was ARFS defined as macroscopically incomplete resection or abdominal recurrence or death of any cause, whichever occurred first. Results: STRASS included 266 patients, STREXIT included 831 patients (727 after excluding patients who received preoperative chemotherapy, 202 after 1:1 PS-matching). The effect of RT on ARFS in STRASS and 1:1 PS-matched STREXIT cohorts, overall and in patients with liposarcoma, was similar. In the pooled cohort analysis, RT administration was associated with better ARFS in patients with liposarcoma [N=321, hazard ratio (HR), 0.61; 95% confidence interval (CI), 0.42-0.89]. In particular, patients with well-differentiated liposarcoma and G1-2 dedifferentiated liposarcoma (G1-2 DDLPS, n=266) treated with RT+S had better ARFS (HR, 0.63; 95% CI, 0.40-0.97) while patients with G3 DDLPS and leiomyosarcoma had not. At the current follow-up, there was no association between RT and overall survival or distant metastases-free survival. Conclusions: In this study, preoperative RT was associated with better ARFS in patients with primary well-differentiated liposarcoma and G1-2 DDLPS.

AB - Objective: The aim of the present study was to compare the effect of radiotherapy (RT) on abdominal recurrence-free survival (ARFS) in patients with primary retroperitoneal sarcoma treated in the EORTC-STBSG-62092 (STRASS) phase 3 randomized controlled trial (STRASS cohort) and off-trial (STREXIT cohort) and to pool STRASS and STREXIT data to test the hypothesis that RT improves ARFS in patients with liposarcoma. Background: The STRASS trial did not show any difference in ARFS between patients treated with preoperative radiotherapy+surgery (RT+S) versus surgery alone (S). Methods: All consecutive adult patients not enrolled in STRASS and underwent curative-intent surgery for a primary retroperitoneal sarcoma with or without preoperative RT between 2012 and 2017 (STRASS recruiting period) among ten STRASS-recruiting centres formed the STREXIT cohort. The effect of RT in STREXIT was explored with a propensity score (PS)-matching analysis. Primary endpoint was ARFS defined as macroscopically incomplete resection or abdominal recurrence or death of any cause, whichever occurred first. Results: STRASS included 266 patients, STREXIT included 831 patients (727 after excluding patients who received preoperative chemotherapy, 202 after 1:1 PS-matching). The effect of RT on ARFS in STRASS and 1:1 PS-matched STREXIT cohorts, overall and in patients with liposarcoma, was similar. In the pooled cohort analysis, RT administration was associated with better ARFS in patients with liposarcoma [N=321, hazard ratio (HR), 0.61; 95% confidence interval (CI), 0.42-0.89]. In particular, patients with well-differentiated liposarcoma and G1-2 dedifferentiated liposarcoma (G1-2 DDLPS, n=266) treated with RT+S had better ARFS (HR, 0.63; 95% CI, 0.40-0.97) while patients with G3 DDLPS and leiomyosarcoma had not. At the current follow-up, there was no association between RT and overall survival or distant metastases-free survival. Conclusions: In this study, preoperative RT was associated with better ARFS in patients with primary well-differentiated liposarcoma and G1-2 DDLPS.

KW - STRASS

KW - STREXIT

KW - radiotherapy

KW - recurrence

KW - retroperitoneal sarcoma

KW - sarcoma

KW - survival

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DO - 10.1097/SLA.0000000000005492

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JO - Annals of Surgery

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