Long-term results of a prospective trial of preoperative radiation and postoperative brachytherapy for retroperitoneal sarcoma
Bibliographic record
Abstract
9007 Background: Recent single-institution series report a 5-year survival of approximately 50% after resection alone for retroperitoneal sarcoma (RPS). We evaluated the effects of preoperative external-beam radiation (XRT) and postoperative brachytherapy (BT) in a prospective trial for patients with resectable RPS. Methods: Between June 1996 and November 2002, 54 patients completed preop XRT and underwent total gross resection. Initially, all patients were treated with BT in the early postoperative period. When we found that BT to the upper abdomen was associated with a high rate of morbidity, the protocol was modified and BT was used only selectively in the lower abdomen. Survival curves were generated using the Kaplan-Meier method, and compared using Cox proportional hazards. Statistical significance was set at p≤0.05. Minimum follow-up was 24 mo, and median follow-up was 47 mo. Results: In the total group of 54 patients, 31 were female, median age was 58 yr (38–79), and median tumor size was 19 cm (3–40). 76% presented with primary RPS and 24% with recurrent disease. 44% had low grade tumors and 56% high grade. Preoperative XRT was well-tolerated, with RTOG scores ≤2 in all patients. 5 yr. overall survival (OS) was 75% (95% CI, 69–81%). 16 patients relapsed during the follow-up interval, but 5 of these were re-resected and rendered disease-free (DF). 5 yr DFS was 71% (64–78%). Grade was the only significant predictor of OS and DFS. There was no difference in age, gender, tumor size, presentation or grade between the patients who received BT (n=19) and those who did not (n=35). Of those treated with BT, 4 experienced life-threatening postoperative morbidity, and 6 significant chronic toxicity. BT was not associated with improved OS or DFS. Conclusions: In long-term follow-up, combined management of RPS with preoperative XRT and complete resection was associated with promising oncologic outcomes. These results highlight the importance of the current ACOSOG trial of preop XRT vs surgery alone. BT was associated with significant morbidity and did not confer any survival advantage. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".