1437P - Effectiveness of regional hyperthermia with chemotherapy for high-risk retroperitoneal and abdominal soft-tissue sarcoma after complete surgical re...

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Soft Tissue Sarcomas
Surgery and/or Radiotherapy of Cancer
Presenter Lars Lindner
Citation Annals of Oncology (2014) 25 (suppl_4): iv494-iv510. 10.1093/annonc/mdu354
Authors L.H. Lindner1, M. Albertsmeier2, N. Prix2, P. Hohenberger3, S. Abdel-Rahman4, N. Dieterle4, M. Schmidt5, U. Mansmann5, C. Bruns6, K. Jauch2, R. Issels7, M. Angele2
  • 1Medical Clinic Iii, University Hospital of Munich, 81377 - Munich/DE
  • 2Department Of General, Visceral, Transplantation, Vascular, And Thoracic Surgery, University of Munich, 81377 - Munich/DE
  • 3Sarcoma Unit Itm – Interdisciplinary Tumor Center Mannheim, Mannheim University Medical Center, Mannheim/DE
  • 4Medical Clinic Iii, University of Munich, Munich/DE
  • 5Institute Of Medical Informatics, Biometry, And Epidemiology, University of Munich, Munich/DE
  • 6Department Of General, Visceral, And Vascular Surgery, University Hospital Magdeburg, Magdeburg/DE
  • 7Dept. Of Medicine Iii, Ludwig Maximilians University - Grosshadern, DE-81377 - M/DE

Abstract

Aim

To determine whether regional hyperthermia (RHT) in addition to chemotherapy improves local tumor control after macroscopically complete resection of abdominal or retroperitoneal high-risk sarcomas. Summary background data: Within the prospectively randomized EORTC 62961 phase-III trial, RHT and systemic chemotherapy significantly improved local progression-free (LPFS) and disease-free survival (DFS) in patients with abdominal and extremity sarcomas. The trial included macroscopically complete and R2 resections.

Methods

A subgroup analysis of the EORTC trial was performed and long-term survival determined. From 341 patients, 149 (median age 52 years, 18-69) were identified with macroscopic complete resection (R0, R1) of abdominal and retroperitoneal soft-tissue sarcomas (median diameter 10 cm, G2 48.3%, G3 51.7%). 76 patients were treated with EIA (etoposide, ifosfamide, doxorubicin)+RHT (>= 5 cycles: 69.7%) vs. 73 patients receivng EIA alone (>= 5 cycles: 52.1%, p=0.027). LPFS and DFS as well as overall survival were determined.

Results

RHT and systemic chemotherapy significantly improved LPFS (56% vs. 45% after 5 years, p=0.044) and DFS (34% vs. 27% after 5 years, p=0.040). Overall survival was not significantly improved in the RHT group (57% vs. 55% after 5 years, p=0.82). Perioperative morbidity and mortality were not significantly different between groups.

Conclusions

In patients with macroscopically complete tumor resection, RHT in addition to chemotherapy resulted in significantly improved local tumor control and DFS without increasing surgical complications. Within a multimodal therapeutic concept for abdominal and retroperitoneal high-risk sarcomas, RHT is a treatment option beside radical surgery and should be further evaluated in future trials.

Disclosure

All authors have declared no conflicts of interest.