Published October 3, 2022
| Version v1
Journal article
Overall survival in patients with re-excision of positive microscopic margins of limb and trunk wall soft tissue sarcoma operated outside of a reference center: a nationwide cohort analysis
Creators
- Gouin, Francois
- Stoeckle, Eberhard
- Honoré, Charles
- Ropars, Mickael
- Jafari, Mehrdad
- Mattei, Jean Camille
- Rochwerger, Alexandre
- Carrere, Sébastien
- Waast, Denis
- Ferron, Gwenaël
- Machiavello, Jean-Christophe
- Anract, Philippe
- Marchal, Frédéric
- Sirveaux, François
- Marco, Oren
- Guiramand, Jérôme
- Paquette, Brice
- Di Marco, Antonio
- Causeret, Sylvain
- Guilloit, Jean-Marc
- Soibinet, Pauline
- Tzanis, Dimitri
- Gimbergues, Pierre
- Fiorenza, Fabrice
- Dujardin, Franck
- Le Nail, Louis
- Ruzic, Jean-Christophe
- Chemin-Airiau, Claire
- Morelle, Magali
- Meeus, Pierre
- Karanian, Marie
- Le Loarer, François
- Vaz, Gualter
- Blay, Jean-Yves
Contributors
Others:
- Centre Léon Bérard [Lyon]
- Institut Bergonié [Bordeaux] ; UNICANCER
- Institut Gustave Roussy (IGR)
- Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
- Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille) ; Université de Lille-UNICANCER
- Hôpital Privé Clairval [Marseille]
- Aix Marseille Université (AMU)
- Marseille medical genetics - Centre de génétique médicale de Marseille (MMG) ; Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)
- Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM) ; CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
- Centre Hospitalier Universitaire de Nantes = Nantes University Hospital (CHU Nantes)
- Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
- Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL) ; UNICANCER-Université Côte d'Azur (UniCA)
- Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Centre de Recherche en Automatique de Nancy (CRAN) ; Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS)
- Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
- Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Institut Paoli-Calmettes (IPC) ; Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)
- Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
- Centre Hospitalier Universitaire [Strasbourg] (CHU Strasbourg) ; Les Hôpitaux Universitaires de Strasbourg (HUS)
- Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL) ; UNICANCER
- Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC) ; Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)
- Institut Jean Godinot [Reims] ; UNICANCER
- Institut Curie [Paris]
- Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP) ; UNICANCER
- CHU Limoges
- Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
- CHU Trousseau [APHP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- CHU Saint-Pierre ; CHU Saint-Pierre
- Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon
- UNICANCER
- ANR-10-LABX-0061,DEVWECAN,Development Cancer and Targeted Therapies(2010)
Description
Background: This French nationwide NETSARC exhaustive prospective cohort aims to explore the impact of systematic re-excision (RE) as adjuvant care on overall survival (OS), local recurrence free survival (LRFS), and local and distant control (RFS) in patients with soft tissue sarcoma (STS) with positive microscopic margins (R1) after initial resection performed outside of a reference center.Methods: Eligible patients had experienced STS surgery outside a reference center from 2010 to 2017, and had R1 margins after initial surgery. Characteristics and treatment comparisons used chi-square for categorical variables and Kruskall-Wallis test for continuous data. Survival distributions were compared in patients reexcised (RE) or not (No-RE) using a log-rank test. A Cox proportional hazard model was used for subgroup analysis.Results: A total of 1,284 patients had experienced initial STS surgery outside NETSARC with R1 margins, including 1,029 patients with second operation documented. Among the latter, 698 patients experienced re-excision, and 331 were not re-excised. Characteristics were significantly different regarding patient age, tumor site, tumor size, tumor depth, and histotype in the population of patients re-excised (RE) or not (No-RE). The study identified RE as an independent favorable factor for OS (HR 0.36, 95%CI 0.23-0.56, p<0.0001), for LRFS (HR 0.45, 95%CI 0.36-0.56, p<0.0001), and for RFS (HR 0.35, 95%CI 0.26-0.46, p<0.0001).Conclusion: This large nationwide series shows that RE improved overall survival in patients with STS of extremities and trunk wall, with prior R1 resection performed outside of a reference center. RE as part of adjuvant care should be systematically considered.
Abstract
International audienceAdditional details
Identifiers
- URL
- https://hal.science/hal-04811719
- URN
- urn:oai:HAL:hal-04811719v1
Origin repository
- Origin repository
- UNICA