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Preoperative radiotherapy doesn’t improve abdominal recurrence–free survival in retroperitoneal sarcoma

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In the open-label, phase 3 study, 266 patients with localized, primary retroperitoneal sarcoma that was operable and suitable for radiotherapy, who had not been previously treated, were randomly assigned to receive surgery alone (n = 133) or preoperative radiotherapy followed by surgery (n =133). Patients were followed for a median of 43.1 months.

Overall, 128 patients had surgery in the surgery alone group and 119 patients in the radiotherapy and surgery group underwent radiotherapy and surgery.

Median abdominal recurrence-free survival was 4.5 years and 5.0 years in the in the radiotherapy plus surgery group and the surgery only group, respectively.

Common grade 3–4 adverse events included lymphopenia (77% in the radiotherapy plus surgery group vs 1% in the surgery alone group), anemia (12% vs 8%), and hypoalbuminaemia (12% vs 4%).

In the radiotherapy plus surgery group, 24% of patients reported serious adverse events compared to 10% in the surgery alone group; 1 patient in the radiotherapy plus surgery group died as a result of a treatment-related serious adverse event.

The authors concluded that “Preoperative radiotherapy should not be considered as standard of care treatment for retroperitoneal sarcoma.”

Bonvalot S, Gronchi A, Le Pechoux, et al. Preoperative radiotherapy plus surgery versus surgery alone for patients with primary retroperitoneal sarcoma (EORTC-62092: STRASS): a multicentre, open-label, randomised, phase 3 trial. Lancet. 2020; DOI:https://doi.org/10.1016/S1470-2045(20)30446-0