Kim Young Rak, Lee Chang-Hyun, Park Hangeul, Kim Jun-Hoe, Kim Chi Heon
Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongro-gu, 03080, Seoul, South Korea.
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea.
Sci Rep. 2025 Jan 8;15(1):1345. doi: 10.1038/s41598-024-84636-1.
The efficacy of preoperative radiotherapy combined with surgery (preRT + S) for primary retroperitoneal sarcoma (RPS) remains unclear. This study aimed to compare preRT + S with surgery alone (SA) in patients with RPS. Core databases were searched for directly comparative studies depending on preRT. Thirteen studies included 2,439 patients with SA and 1,453 with preRT + S. PreRT + S in all RPS patients led to significantly low local recurrence (LR) (hazard ratios [HR],0.575; p = 0.008) compared to SA. Among the liposarcoma patients, PreRT + S did not clearly affect LR or abdominal recurrence-free survival (ARFS). Excluding dedifferentiated liposarcoma (DDLPS), the patients underwent preRT + S significantly improved LR (HR,0.430; p = 0.002) and ARFS (HR,0.706; p = 0.045). In another subgroup analysis of patients with well-differentiated liposarcoma and grade 1-2 DDLPS, preRT + S significantly extended ARFS (HR,0.601; p = 0.014) compared to SA. There was no significant difference in overall survival (OS) (HR,0.904; p = 0.362 [RPS]; HR,0.724; p = 0.348 [WDLPS + G1-2DDLPS]) between preRT + S and SA in all comparisons. PreRT + S group demonstrated higher incidence of total (odds ratio [OR],1.580; p = 0.007) and severe (OR,3.680; p = 0.004) complications than the SA group. PreRT + S prevent recurrence in patients with WDLPS and low-grade DDLPS but is associated with increased complications, resulting in similar OS compared to SA.
术前放疗联合手术（preRT + S）治疗原发性腹膜后肉瘤（RPS）的疗效仍不明确。本研究旨在比较RPS患者接受preRT + S与单纯手术（SA）的效果。根据preRT检索核心数据库以查找直接比较研究。13项研究纳入了2439例接受SA的患者和1453例接受preRT + S的患者。与SA相比，所有RPS患者接受preRT + S后局部复发（LR）显著降低（风险比[HR]，0.575；p = 0.008）。在脂肪肉瘤患者中，preRT + S对LR或无腹内复发生存期（ARFS）无明显影响。排除去分化脂肪肉瘤（DDLPS）后，接受preRT + S的患者LR（HR，0.430；p = 0.002）和ARFS（HR，0.706；p = 0.045）显著改善。在另一项对高分化脂肪肉瘤和1 - 2级DDLPS患者的亚组分析中，与SA相比，preRT + S显著延长了ARFS（HR，0.601；p = 0.014）。在所有比较中，preRT + S与SA之间的总生存期（OS）无显著差异（HR，0.904；p = 0.362 [RPS]；HR，0.724；p = 0.348 [高分化脂肪肉瘤+1 - 2级DDLPS]）。preRT + S组的总并发症（优势比[OR]，1.580；p = 0.007）和严重并发症（OR，3.680；p = 0.004）发生率高于SA组。preRT + S可预防高分化脂肪肉瘤和低级别DDLPS患者的复发，但与并发症增加相关，导致OS与SA相似。
