Scientific Publications Database

Article Title: Predicting Survival in Patients Undergoing Resection for Locally Recurrent Retroperitoneal Sarcoma: A Study and Novel Nomogram from TARPSWG
Authors: Raut, Chandrajit P.; Callegaro, Dario; Miceli, Rosalba; Barretta, Francesco; Rutkowski, Piotr; Blay, Jean-Yves; Lahat, Guy; Strausss, Dirk C.; Gonzalez, Ricardo; Ahuja, Nita; Grignani, Giovanni; Quagliuolo, Vittorio; Stoeckle, Eberhard; De Paoli, Antonino; Pillarisetty, Venu G.; Nessim, Carolyn; Swallow, Carol J.; Bagaria, Sanjay; Canter, Robert; Mullen, John; Gelderblom, Hans J.; Pennacchioli, Elisabetta; van Coevorden, Frits; Cardona, Kenneth; Fiore, Marco; Fairweather, Mark; Gronchi, Alessandro
Journal: CLINICAL CANCER RESEARCH Volume 25 Issue 8
Date of Publication:2019
Abstract:
Purpose: The role of surgery for first relapse locally recurrent retroperitoneal sarcoma (RPS-LR1) is uncertain. We report outcomes of the largest RPS-LR1 series and propose a new prognostic nomogram.Experimental Design: Patients with consecutive RPS-LR1 without distant metastases who underwent resection at 22 centers (2002-2011) were included. Endpoints were disease-free and overall survival (DFS, OS) and crude-cumulative-incidence (CCI) of local/distant recurrence from second surgery. Nomograms predicting DFS and OS from second surgery were developed and validated (calibration plots); discrimination was assessed (Harrell C index).Results: Of 684 patients identified, full prognostic variable data were available for 602. Initial surgery for primary RPS was performed at our institutions in 188 patients (31%) and elsewhere in 414 (69%). At a median follow-up of 119 months [Interquartile range (IQR), 80-169] from initial surgery and 75 months (IQR 50-105) from second surgery, 6-year DFS and OS were 19.2% [95% confidence interval (CI), 16.0-23.0%] and 54.1% (95% CI, 49.8-58.8%), respectively. Recurrence patterns and survival probability were histology-specific, with liposarcoma subtypes having the highest 6-year CCI of second local recurrence (LR, 60.2%-70.9%) and leiomyosarcoma (LMS) having higher 6-year CCI of distant metastasis (DM, 36.3%). Nomograms included age at second surgery, multifocality, grade, completeness of second surgery, histology, chemotherapy/radiotherapy at first surgery, and number of organs resected at first surgery. OS and DFS nomograms showed good calibration and discriminative ability (C index 0.70 and 0.67, respectively).Conclusions: We developed nomograms to predict DFS and OS for patients undergoing RPS-LR1 resection. Nomograms provide individualized, disease-relevant estimations of survival for RPS-LR1 patients and assist in clinical decisions.