Abstract 4068
Background
Surgery for retroperitoneal sarcomas (RPS) is more and more standardized worldwide. Yet, the potential benefits of preoperative chemotherapy remain elusive.
Methods
All consecutive patients operated on for a primary RPS were retrospectively identified. Preoperative chemotherapy was mostly a doxorubicin-based chemotherapy regimen for 2 to 6 cycles. Surgery was performed according to the “cluster resection” principles. A caliper restricted, propensity score matched analysis was used to balance the groups.
Results
249 patients were identified, 49(19.7%) of whom had receive preoperative chemotherapy. After matching, 40 pairs of patients were available and well balanced for baseline characteristics. Seven patients had intermediate adipocytic tumors, 30 had malignant adipocytic tumor, 19 had smooth muscle tumors and 24 had other subtypes. The median tumor size at diagnosis was 20 cm (IQR: 12-26 cm). Sixteen tumors (%) were FNCLCC’s grade 1, 28 (%) grade 2 and 36 (%) grade 3. Univariate analysis identified the size of the tumor (p = 0.036), the histological subtype (p = 0.0015), the FNCLCC’s grade (p = 0.0027) and the postoperative chemotherapy (p = 0.01) as prognostic factors. In the multivariate analysis, only the sarcoma histotype (p = 0.013) and the FNCLCC’s grade (p = 0.022) were retained as independent prognostic factor. Preoperative chemotherapy was neither associated with overall survival (p = 0.41) nor disease-free survival (p = 0.11).
Conclusions
Routine use of chemotherapy should be avoided in the preoperative setting of primary RPS. Targeted treatments and/or accurate selection criteria are needed.
Clinical trial identification
Legal entity responsible for the study
Gustave Roussy.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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