Radiotherapy Offered Limited Additional Benefits on Cancer-specific Survival for Patients with Resectable Subcutaneous Malignant Peripheral Nerve Sheath Tumors: A Population-based Retrospective Cohort Analysis

For resectable malignant peripheral nerve sheath tumors, the additional benefits of radiotherapy remain controversial. This study aims to investigate whether there is an additional benefit of radiotherapy for resectable malignant peripheral nerve sheath tumors. We retrospectively collected data on malignant peripheral nerve sheath tumor cases from the Surveillance, Epidemiology, and End Results database. Overall, 926 malignant peripheral nerve sheath tumor cases occurred in soft tissues, with surgical resection performed in 783 cases. After excluding cases with distant metastasis, incomplete follow-up, rare tumor sites, and unrecorded tumor diameter, 339 malignant peripheral nerve sheath tumor cases with highly complete information were included in the study. Cox analysis and propensity score matching were used to evaluate the prognosis. Cancer-specific survival was selected as the endpoint for this study. Subgroup analyses were applied based on tumor diameters and sites. In both regressions on total and post-propensity score matching data, radiotherapy was not identified as an independent risk factor for cancer-specific survival. Further results from subgroup analyses indicated that radiotherapy was not a significant risk factor for cancer-specific survival in each subgroup of the total study data and the post-propensity score matching data. In conclusion, radiotherapy provided limited benefits on Cancer-specific survival for resectable malignant peripheral nerve sheath tumors. Subgroup analyses based on tumor diameter and location also failed to demonstrate positive outcomes. However, the benefits of radiotherapy for controlling local tumor recurrence still need to be explored through prospective randomized controlled clinical trials in the future.