Farooq Mohammad S, Shafique Neha, Vargas Gracia M, Guo Jennifer, Miura John T, Lefler Daniel S, Karakousis Giorgos C
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Surg Oncol. 2025 Jun;131(8):1683-1691. doi: 10.1002/jso.28155. Epub 2025 May 13.
Neoadjuvant immunotherapy (NIT) with checkpoint blockade has been increasingly studied for soft tissue sarcomas, however, survival outcomes data are limited, and dedifferentiated liposarcoma (DDLPS) histology remains underrepresented in recent trial cohorts. We assessed the impact of NIT with or without radiation therapy (RT) on overall survival (OS) for resectable DDLPS.
The National Cancer Database (NCDB) was used to identify patients diagnosed with nonmetastatic DDLPS who received NIT and underwent surgical resection between 2016 and 2022. Primary outcome was 5-year OS.
A total of 3414 patients with DDLPS met the inclusion criteria and NIT was administered to 31 (1%) patients. Factors associated with receipt of NIT were receipt of neoadjuvant RT (NRT, odds ratio [OR]: 5.75, p < 0.001) and male sex (OR: 3.33, p = 0.036). NIT was associated with a hazard ratio (HR) for mortality of 0.89 (p = 0.786). No difference was found in 5-year OS in the overall cohort (NIT 72% vs. 61% no NIT, p = 0.320) or in the propensity-matched cohort (68% vs. 65%, p = 0.848). Subanalysis between NIT with NRT versus NRT-only also did not find any significant difference in 5-year OS (88% vs. 59%, p = 0.331).
In this retrospective NCDB analysis of patients with resectable DDLPS, administration of NIT did not significantly affect OS.
针对软组织肉瘤，采用检查点阻断的新辅助免疫疗法（NIT）的研究日益增多，然而，生存结果数据有限，且在近期的试验队列中，去分化脂肪肉瘤（DDLPS）组织学类型的代表性仍然不足。我们评估了联合或不联合放射治疗（RT）的NIT对可切除性DDLPS总生存期（OS）的影响。
利用国家癌症数据库（NCDB）确定2016年至2022年间被诊断为非转移性DDLPS且接受NIT并接受手术切除的患者。主要结局为5年总生存期。
共有3414例DDLPS患者符合纳入标准，31例（1%）患者接受了NIT。与接受NIT相关的因素包括接受新辅助放疗（NRT，比值比[OR]：5.75，p<0.001）和男性（OR：3.33，p=0.036）。NIT与死亡风险比（HR）为0.89（p=0.786）相关。在整个队列中（接受NIT组为72%，未接受NIT组为61%，p=0.320）或倾向匹配队列中（68%对65%，p=0.848），5年总生存期均未发现差异。NIT联合NRT与单纯NRT之间的亚组分析在5年总生存期方面也未发现任何显著差异（88%对59%，p=0.331）。
在这项对可切除性DDLPS患者的回顾性NCDB分析中，给予NIT并未显著影响总生存期。
