AI Article Synopsis
- The study investigates prognostic factors and long-term outcomes in patients with locally recurrent pelvic cancer (LRPC) treated through a multidisciplinary method.
- After analyzing data from 81 patients over approximately 16 years, the results showed that the combination of extended surgery and intraoperative radiation therapy yielded positive outcomes.
- Key factors linked to better locoregional control included undergoing radical resection, avoiding tumor fragmentation, and incorporating external beam radiation therapy (EBRT) during treatment.
Article Abstract
Purpose: To analyze prognostic factors and long-term outcomes in patients with locally recurrent pelvic cancer (LRPC) treated with a multidisciplinary approach.
Methods And Materials: From January 1995 to December 2011, 81 patients [rectal (47 %); gynecologic (39 %); retroperitoneal sarcoma (14 %)] underwent extended surgery [multiorgan (58 %), bone (35 %), vascular (9 %), soft tissue (63 %)] and intraoperative electron beam radiation therapy (IOERT) to treat recurrent tumors in the pelvic region. Thirty-five patients (43 %) received external beam radiotherapy (EBRT). Survival was estimated using the Kaplan-Meier method, and risk factors were identified using univariate and multivariate analysis.
Results: Median follow-up was 39 months (6-189 months); the 1- 3- and 5-year rates of locoregional control (LRC) were 83, 53, and 41 %, respectively. Univariate Cox proportional hazard analysis revealed worse LRC in patients who did not receive integrated EBRT as rescue treatment of pelvic recurrence (p = 0.003) or underwent non-radical resection (p = 0.01). In the multivariate analysis EBRT, non-radical resection, and tumor fragmentation retained significance (p = 0.002, p = 0.004, and p = 0.05, respectively).
Conclusions: Radical resection, absence of tumor fragmentation and addition of EBRT for rescue are associated with improved LRC in patients with LRPC. Our results suggest that this group can benefit from EBRT combined with extended surgical resection and IOERT.
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| http://dx.doi.org/10.1007/s00432-014-1667-6 | DOI Listing |
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