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Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis
Chenghua Luo
Peking University International Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2453-3429
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 by pooling analysis.
Methods
We searched PubMed, Web of Science, Embase, ASCO Abstracts, and Cochrane Library for comparative studies (until January 2020) comparing 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 (95%CI). Risk of bias of studies was assessed with Begg’s and Egger’s tests.
Results
A total of 15 trials were eligible, including 9076 adjuvant therapy and 20830 surgery alone cases (20 studies for OS, 6 studies for RFS, 2 studies for LR, and 2 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, 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.
Keywords
Meta-analysis, Retroperitoneal sarcoma, Adjuvant therapy, surgery
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CURRENT STATUS: Under Revision
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Received 17 Jan, 2021
Editorial decision: Minor revision
On 17 Jan, 2021
Reviewer #2 agreed
On 04 Jan, 2021
Review #1 received
Received 01 Jan, 2021
Reviewer #1 agreed
On 20 Dec, 2020
Reviewers invited
Invitations sent on 15 Dec, 2020
First submitted
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On 13 Dec, 2020
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On 13 Dec, 2020
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This preprint is under consideration at Radiation Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Adjuvant therapy for retroperitoneal sarcoma: a meta-analysis
Chenghua Luo
Peking University International Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2453-3429
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 17 Dec, 2020
No community comments so far
Review #2 received
Received 17 Jan, 2021
Editorial decision: Minor revision
On 17 Jan, 2021
Reviewer #2 agreed
On 04 Jan, 2021
Review #1 received
Received 01 Jan, 2021
Reviewer #1 agreed
On 20 Dec, 2020
Reviewers invited
Invitations sent on 15 Dec, 2020
First submitted
On 13 Dec, 2020
Editor assigned
On 13 Dec, 2020
Submission checks complete
On 13 Dec, 2020
Editor invited
On 13 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 by pooling analysis.
Methods
We searched PubMed, Web of Science, Embase, ASCO Abstracts, and Cochrane Library for comparative studies (until January 2020) comparing 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 (95%CI). Risk of bias of studies was assessed with Begg’s and Egger’s tests.
Results
A total of 15 trials were eligible, including 9076 adjuvant therapy and 20830 surgery alone cases (20 studies for OS, 6 studies for RFS, 2 studies for LR, and 2 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, 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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