Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar;32(3):1541-1549.
doi: 10.1245/s10434-024-16703-w. Epub 2024 Dec 16.

The Impact of Perioperative Radiotherapy on Disease-Specific Survival in Patients with Localized Retroperitoneal Liposarcoma: A Population-Based Propensity-Score Matched Analysis

Alexander Wilhelm  1   2 , Benjamin Wiesler #  3   4 , Christoph Kümmerli  3 , Markus W Gross  5 , Christoph Kettelhack  3 , Beat P Müller  3   4
Affiliations

The Impact of Perioperative Radiotherapy on Disease-Specific Survival in Patients with Localized Retroperitoneal Liposarcoma: A Population-Based Propensity-Score Matched Analysis

Alexander Wilhelm et al. Ann Surg Oncol. 2025 Mar.

Abstract

Background: The impact of radiotherapy on the oncologic outcome of retroperitoneal liposarcoma (RPLS) remains controversial. The aim of this study was to evaluate the effect of radiotherapy on disease-specific survival (DSS) in a cohort of patients with RPLSs.

Methods: In this population-based, retrospective cohort study, patients with localized RPLSs who underwent surgical therapy were identified from the Surveillance, Epidemiology, and End Results-17 cancer registry program. After propensity-score matching for potential confounders, multivariable logistic and Cox regression analyses were used to examine factors associated with DSS and radiotherapy.

Results: From 2004 to 2020, 1692 patients with localized RPLS who underwent surgical therapy were identified (84.2% White, 44.6% female, mean age 62 years). Of those patients, 393 patients (23.2%) received perioperative radiotherapy. Patients who received radiotherapy had a higher rate of tumor size between 10 and 20 cm and unknown tumor grading. After propensity-score matching, multivariable adjusted Cox regression and Kaplan-Meier survival analysis demonstrated no improvement of DSS for patients who underwent radiotherapy (hazard ratio 1.04, confidence interval 0.81-1.32; log-rank p = 0.47). Patient age ≥80 years, larger tumor size, and tumor grading G3 versus G1/2 were associated with an increased risk of death due to RPLS. Subgroup analyses stratified by grading showed similar outcomes.

Conclusions: The administration of perioperative radiotherapy did not improve DSS in patients undergoing surgery for localized RPLS in this population-based study. Therefore, the use of perioperative radiotherapy in these patients may be questioned. However, the findings should be interpreted with caution due to the inherent limitations of the Surveillance, Epidemiology, and End Results (SEER) database.

Keywords: Disease-specific survival; Overall survival; Population-based study; Propensity score matching; Radiotherapy; Retroperitoneal liposarcoma; Retroperitoneal sarcoma; SEER.

PubMed Disclaimer

Conflict of interest statement

DISCLOSURE: Alexander Wilhelm, Benjamin Wiesler, Christoph Kümmerli, Markus W. Gross, Christoph Kettelhack, and Beat P. Müller declare they have no non-financial or financial conflicts of interest to declare that may be relevant to the contents of this study.

Figures

Fig. 1
Fig. 1
Participant flow diagram. LPS liposarcoma, NOS LPS liposarcoma not otherwise specified, WD LPS well-differentiated liposarcoma, mLPS myxoid liposarcoma, rcLPS round cell liposarcoma, plLPS pleomorphic liposarcoma, mixLPS mixed liposarcoma, DD LPS dedifferentiated liposarcoma, PSM propensity score matching, SEER Surveillance, Epidemiology, and End Results
Fig. 2
Fig. 2
Disease-specific survival of patients with localized retroperitoneal liposarcoma who underwent surgery between 2004 and 2020 after propensity score matching
Fig. 3
Fig. 3
Overall survival of patients with localized retroperitoneal liposarcoma who underwent surgery between 2004 and 2020 after propensity score matching
Fig. 4
Fig. 4
Subgroup analysis of disease-specific survival in patients with G1 and G2 localized retroperitoneal liposarcoma who underwent surgery after propensity score matching
See this image and copyright information in PMC

References

    1. Leffall LD Jr. Retroperitoneal sarcoma. Ann Surg. 1991;214(1):1. - PMC - PubMed
    1. Nazzani S, Bandini M, Marchioni M, et al. A contemporary analysis of radiotherapy effect in surgically treated retroperitoneal sarcoma. Radiother Oncol. 2018;127(2):318–25. - DOI - PubMed
    1. Salerno KE, Baldini EH. Role of Radiation Therapy in Retroperitoneal Sarcoma. J Natl Compr Cancer Netw. 2022;20(7):845–9. - DOI - PubMed
    1. Swallow CJ, Strauss DC, Bonvalot S, et al. Management of primary retroperitoneal sarcoma (RPS) in the adult: an updated consensus approach from the transatlantic australasian RPS working group. Ann Surg Oncol. 2021;28(12):7873–88. - DOI - PMC - PubMed
    1. Salerno KE, Alektiar KM, Baldini EH, et al. Radiation therapy for treatment of soft tissue sarcoma in adults: executive summary of an astro clinical practice guideline. Pract Radiat Oncol. 2021;11(5):339–51. - DOI - PubMed

MeSH terms

Supplementary concepts

LinkOut - more resources