Improving Long-Term Outcomes for Patients with Extra-Abdominal Soft Tissue Sarcoma Regionalization to High-Volume Centers, Improved Compliance with Guidelines or Both?

Sarcoma
Sanjay P BagariaNabil Wasif

Abstract

Optimization of outcomes of extra-abdominal STS is not clearly understood. We sought to determine whether hospital surgical volume and adherence to NCCN guidelines, or both, are associated with outcomes in the treatment of extra-abdominal soft tissue sarcoma (STS). The National Cancer Database (NCDB) was queried for patients undergoing surgery for extra-abdominal STS diagnosed from 2003 to 2007. Mean annual hospital volume for STS surgery was divided into volume terciles (1T ≤3, 2T 4-10, and 3T ≥11 cases/year). Adherence to NCCN guidelines was determined. Primary outcome was overall survival. Our study population consisted of 13,684 patients with a median age of 56 years. 3T hospitals were more likely to adhere to NCCN guidelines for stage III patients (63% versus 47%; p ≤ 0.001) than 1T hospitals. On multivariable analysis, adherence to NCCN guidelines was associated with improved survival (HR = 0.79, CI 0.73-0.87; p < 0.001), but hospital volume was not (3T versus 1T: HR = 0.92, CI 0.82-1.02; p=0.12). Five-year overall survival was comparable for compliant groups at 1T, 2T, and 3T hospitals (72%, 72.4%, and 72.6%, resp.). 3T hospitals were not associated with a lower risk of 30-day mortality (OR 0.70, 95% CI 0.44-1.11) compar...Continue Reading

References

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Citations

Mar 2, 2019·The Oncologist·Vicente Valenti
Mar 9, 2019·The Oncologist·Javier Martin-Broto, Nadia Hindi
May 10, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Eliza W BealTimothy M Pawlik
Dec 12, 2020·Seminars in Musculoskeletal Radiology·Iris-M Noebauer-HuhmannJohan L Bloem
Feb 20, 2021·Urologic Oncology·Jason K FrankelChristopher R Porter
Mar 27, 2021·American Society of Clinical Oncology Educational Book·Thierry AlcindorDavid M Thomas
Jan 29, 2020·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J-Y BlayUNKNOWN NETSARC/REPPS/RESOS and French Sarcoma Group–Groupe d’Etude des Tumeurs Osseuses (GSF-GETO) Networks

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Methods Mentioned

BETA
biopsies
amputation
surgical resection
pancreatectomy

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