Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis

被引:8
|
作者
Li, Xiangji [1 ,4 ]
Wu, Tong [2 ]
Xiao, Mengmeng [1 ]
Wu, Shanshan [3 ]
Min, Li [4 ]
Luo, Chenghua [1 ]
机构
[1] Peking Univ Int Hosp, Dept Retroperitoneal Tumor Surg, 1 ShengMingYuan Rd, Beijing 102206, Peoples R China
[2] Peking Univ, Peking Univ Third Hosp, Beijing Key Lab Sports Injuries, Dept Sports Med,Inst Sports Med, Beijing, Peoples R China
[3] Capital Med Univ, Beijing Friendship Hosp, Natl Clin Res Ctr Digest Dis, Clin Epidemiol & EBM Unit, Beijing, Peoples R China
[4] Capital Med Univ, Beijing Friendship Hosp, Natl Clin Res Ctr Digest Dis,Beijing Digest Dis C, Dept Gastroenterol,Beijing Key Lab Precancerous L, Beijing, Peoples R China
关键词
Meta-analysis; Retroperitoneal sarcoma; Adjuvant therapy; Surgery; SOFT-TISSUE SARCOMA; POPULATION-BASED-ANALYSIS; RADIATION-THERAPY; RADIOTHERAPY; SURVIVAL; SURGERY; RESECTION; CHEMOTHERAPY; MULTICENTER;
D O I
10.1186/s13014-021-01774-w
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Adjuvant therapy is a promising treatment to improve the prognosis of cancer patients, however, the evidence base driving recommendations for adjuvant radiotherapy (ART) or chemotherapy (ACT) in retroperitoneal sarcomas (RPS) primarily hinges on observational data. The aim of this study was to evaluate the effectiveness of adjuvant therapy in the management of RPS patients. Methods We searched PubMed, Web of Science, Embase, ASCO Abstracts, and Cochrane Library for comparative studies (until December 2020) of adjuvant therapy versus surgery alone. Data on the following endpoints were evaluated: overall survival (OS), local recurrence (LR), recurrence-free survival (RFS), and metastasis-free survival (MFS). Data were summarized as hazard ratios (HR) with 95% confidence intervals (CI). Risk of bias of studies was assessed with Begg's and Egger's tests. Results A total of 15 trials were eligible, including 9281 adjuvant therapy and 21,583 surgery alone cases (20 studies for OS, six studies for RFS, two studies for LR, and two studies for MFS). Meta-analysis showed that ART was associated with distinct advantages as compared to surgery alone, including a longer OS (HR = 0.80, P < 0.0001), a longer RFS (HR = 0.61, P = 0.0002), and a lower LR (HR = 0.31, P = 0.005). However, this meta-analysis failed to demonstrate a benefit of ACT for RPS patients, including OS (HR = 1.11, P = 0.19), RFS (HR = 1.30, P = 0.09) and MFS (HR = 0.69, P = 0.09). In the sensitivity analysis, ACT was associated with a worse OS (HR = 1.19, P = 0.0002). No evidence of publication bias was observed. Conclusions Overall, the quality of the evidence was moderate for most outcomes. The evidence supports that ART achieved a generally better outcome as compared to surgery alone.
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页数:11
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