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Sarcoma
Volume 2015, Article ID 186581, 12 pages
http://dx.doi.org/10.1155/2015/186581
Research Article

The Use of Radiation Therapy in Well-Differentiated Soft Tissue Sarcoma of the Extremities: An NCDB Review

1School of Medicine, Duke University, Durham, NC 27710, USA
2Department of Surgery, Division of Orthopedic Surgery, Duke University Medical Center, Durham, NC 27710, USA
3Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
4Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei 10617, Taiwan
5Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA

Received 7 February 2015; Revised 10 April 2015; Accepted 21 April 2015

Academic Editor: Peter C. Ferguson

Copyright © 2015 Alexander L. Lazarides et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. This study investigated patterns of utilization of radiation therapy (RT) and correlated this with overall survival by assessing patients with well-differentiated soft tissue sarcoma of the extremity (STS-E) in the National Cancer Database (NCDB). Methods. All patients diagnosed with well-differentiated STS-E between 1998 and 2006 were identified in the NCDB. Patients were stratified by use of surgery alone versus use of adjuvant RT after surgery and analyzed using multivariate analysis, Kaplan-Meier analysis, and propensity matching. Results. 2113 patients with well-differentiated STS-E were identified in the NCDB for inclusion with a mean follow-up time of 74 months. 69% of patients were treated with surgery alone, while 26% were treated with surgery followed by adjuvant RT. Patients undergoing amputation were less likely to receive adjuvant RT. There was no difference in overall survival between patients with well-differentiated STS treated with surgery alone and those patients who received adjuvant RT. Conclusions. In the United States, adjuvant RT is being utilized in a quarter of patients being treated for well-differentiated STS-E. While the use of adjuvant RT may be viewed as a means to facilitate limb salvage, this large national database review confirms no survival benefit, regardless of tumor size or margin status.