Improved nationwide survival of sarcoma patients with a network of reference centers

被引：21

作者：

Blay, J. Y. ^{[1
,2
,3
]}

Penel, N. ^{[4
]}

Valentin, T. ^{[5
]}

Anract, P. ^{[6
]}

Duffaud, F. ^{[7
]}

Dufresne, A. ^{[1
,2
]}

Verret, B. ^{[8
,9
]}

Cordoba, A. ^{[4
]}

Italiano, A. ^{[10
,11
]}

Brahmi, M. ^{[1
,2
,3
]}

Henon, C. ^{[8
,9
]}

Amouyel, T. ^{[4
]}

Ray-Coquard, I. ^{[1
,2
,3
]}

Ferron, G. ^{[5
]}

Boudou-Rouquette, P. ^{[6
]}

Tlemsani, C. ^{[6
]}

Salas, S. ^{[7
]}

Rochwerger, R. ^{[7
]}

Faron, M. ^{[8
,9
]}

Bompas, E. ^{[12
,13
]}

Ducassou, A. ^{[5
]}

Gangloff, D. ^{[5
]}

Gouin, F. ^{[1
,2
,3
,14
]}

Firmin, N. ^{[15
]}

Piperno-Neumann, S. ^{[16
,17
,18
]}

Rios, M. ^{[19
]}

Ropars, M. ^{[20
]}

Kurtz, J. E. ^{[21
]}

Nail, L. R. Le ^{[22
]}

Bertucci, F. ^{[23
]}

Carrere, S. ^{[14
]}

Llacer, C. ^{[14
]}

Watson, S. ^{[15
]}

Bonvalot, S. ^{[15
]}

Leroux, A. ^{[16
]}

Perrin, C. ^{[24
]}

Gantzer, J. ^{[19
]}

Pracht, M. ^{[24
]}

Narciso, B. ^{[22
]}

Monneur, A. ^{[23
]}

Lebbe, C. ^{[25
,26
]}

Hervieu, A. ^{[27
]}

Saada-Bouzid, E. ^{[28
]}

Dubray-Longeras, P. ^{[29
]}

Fiorenza, F. ^{[30
]}

Chaigneau, L. ^{[31
]}

Nevieres, Z. -M. ^{[31
]}

Soibinet, P. ^{[32
]}

Bouche, O. ^{[33
]}

Guillemet, C. ^{[34
]}

机构：

[1] Ctr Leon Berard, Dept Med Oncol, Lyon, France

[2] Univ Claude Bernard, Lyon, France

[3] Ctr Leon Berard, Dept Surg Oncol, Lyon, France

[4] Ctr Oscar Lambret, Dept Med Oncol, Lille, France

[5] Inst Claudius Regaud & IUCT Oncopole Toulouse, Dept Med Oncol, Toulouse, France

[6] Hop Cochin St Vincent de Paul, Dept Orthoped, Paris, France

[7] La Timone Univ Hosp, Dept Med Oncol, Marseille, France

[8] Gustave Roussy Canc Campus, Dept Med, Villejuif, France

[9] Gustave Roussy Canc Campus, Dept Surg, Villejuif, France

[10] Inst Bergonie, Dept Med Oncol, Bordeaux, France

[11] Inst Bergonie, Dept Surg Oncol, Bordeaux, France

[12] Cochin Hosp, Dept Med Oncol, Paris, France

[13] Ctr Rene Gauducheau, Dept Med Oncol, St Herblain, France

[14] CHU Nantes, Serv Orthopedie, Nantes, France

[15] Dept Med & Surg & Radiotherapy Oncol ICM, Montpellier, France

[16] Univ Montpellier, INSERM U1194, IRCM, Montpellier, France

[17] Inst Curie, Dept Med Oncol, Paris, France

[18] Inst Curie, Dept Surg Oncol, Paris, France

[19] Ctr Alexis Vautrin, Dept Med Oncol, Vandoeuvre Les Nancy, France

[20] CHU Rennes, Dept Orthoped, Strasbourg, France

[21] ICANS, Strasbourg, France

[22] Dept Orthoped Surg, Tours, France

[23] Inst Paoli Calmettes, Dept Med Oncol, Marseille, France

[24] Eugene Marquis Comprehens Canc Ctr, Dept Med Oncol, Rennes, France

[25] Univ Paris, Dept Dermatol, INSERM U976, Diderot St Louis Hosp, Paris, France

[26] Univ Paris, Dept CIC, INSERM U976, Diderot St Louis Hosp, Paris, France

[27] Ctr Georges Francois Leclerc, Dept Med Oncol, Dijon, France

[28] Ctr Antoine Lacassagne, Dept Med Oncol, Nice, France

[29] Ctr Jean Perrin, Dept Med Oncol, Clermont Ferrand, France

[30] CHU Limoges, Dept Orthoped Surg, Limoges, France

[31] CHU Besancon, Dept Med, Besancon, France

[32] Ctr Francois Baclesse, Dept Med, Caen, France

[33] CHU Reims, Dept Gastroenterol, Reims, France

[34] Ctr J Godinot Reims, Dept Med Oncol, Reims, France

[35] Hop La Pitie Salpetriere, Dept Oncol, Paris, France

[36] CHU, Dept oncol, La Reunion, France

[37] CHU Poitiers, Serv Oncol, Poitiers, France

来源：

ANNALS OF ONCOLOGY | 2024年 / 35卷 / 04期

关键词：

sarcoma; network; reference centers; multidisciplinary tumor board; clinical practice guidelines; survival; SOFT-TISSUE SARCOMA; SCANDINAVIAN SARCOMA; TRUNK WALL; UNPLANNED EXCISION; IMPACT; MANAGEMENT; DIAGNOSIS; EXTREMITY; RESECTION; SURGERY;

D O I：

10.1016/j.annonc.2024.01.001

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: We investigated the impact of the implementation of a network of reference centers for sarcomas (NETSARC) on the care and survival of sarcoma patients in France since 2010. Patients and methods: NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor boards (MDTBs), funded by the French National Cancer Institute (INCa) since 2010. Its aims are to improve the quality of diagnosis and care of sarcoma patients. Patients ' characteristics, treatments, and outcomes are collected in a nationwide database. The objective of this analysis was to compare the survival of patients in three periods: 2010-2012 (non -exhaustive), 2013-2015, and 2016-2020. Results: A total of 43 975 patients with sarcomas, gastrointestinal stromal tumors (GISTs), or connective tissue tumors of intermediate malignancy were included in the NETSARC + database since 2010 (n = 9266 before 2013, n = 12 274 between 2013 and 2015, n = 22435 in 2016-2020). Median age was 56 years, 50.5% were women, and 13.2% had metastasis at diagnosis. Overall survival was significantly superior in the period 2016-2020 versus 2013-2015 versus 2010-2012 for the entire population, for patients > 18 years of age, and for both metastatic and non -metastatic patients in univariate and multivariate analyses ( P < 0.0001). Over the three periods, we observed a signi fi cantly improved compliance to clinical practice guidelines (CPGs) nationwide: the proportion of patients biopsied before surgery increased from 62.9% to 72.6%; the percentage of patients presented to NETSARC MDTBs before fi rst surgery increased from 31.7% to 44.4% ( P < 0.0001). The proportion of patients with R0 resection on fi rst surgery increased (from 36.1% to 46.6%), while R2 resection rate decreased (from 10.9% to 7.9%), with a better compliance and improvement in NETSARC centers. Conclusions: The implementation of the national reference network for sarcoma was associated with an improvement of overall survival and compliance to guidelines nationwide in sarcoma patients. Referral to expert networks for sarcoma patients should be encouraged, though a better compliance to CPGs can still be achieved.

引用

页码：351 / 363

页数：13

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