Publication: Relevance of Reference Centers in Sarcoma Care and Quality Item Evaluation: Results from the Prospective Registry of the Spanish Group for Research in Sarcoma (GEIS).
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Identifiers
Date
2018-11-08
Authors
Martin-Broto, Javier
Hindi, Nadia
Cruz, Josefina
Martinez-Trufero, Javier
Valverde, Claudia
De-Sande, Luis M
Sala, Angeles
Bellido, Lorena
De-Juan, Ana
Rubio-Casadevall, Jordi
Advisors
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford University Press
Abstract
Reference centers (RCs) are a key point for improving the survival of patients with soft‐ tissue sarcomas (STS). The aim of this study was to evaluate selected items in the management of patients with STS, comparing results between RC and local hospitals (LHs). Materials and MethodsDiagnostic and therapeutic data from patients diagnosed between January 2004 and December 2011 were collected. Correlation with outcome was performed.ResultsA total of 622 sarcomas were analyzed, with a median follow‐up of 40 months. Imaging of primary tumor preoperatively (yes vs. no) correlated with a higher probability of free surgical margins (77.4% versus 53.7%; p = .006). The provenance of the biopsy (RC vs. LH) significantly affected relapse ‐free survival (RFS; 3‐year RFS 66% vs. 46%, respectively; p = .019). Likewise, 3‐year RFS was significantly worse in cases with infiltrated (55.6%) or unknown (43.4%) microscopic surgical margins compared with free margins (63.6%; p < .001). Patients managed by RCs had a better 3‐year overall survival compared with those managed by LHs (82% vs. 70.4%, respectively; p = .003). Perioperative chemotherapy in high‐ risk STS, more frequently administered in RCs than in LHs, resulted in significantly better 3‐year RFS (66% vs. 44%; p = .011). In addition, patients with stage IV disease treated in RCs survived significantly longer compared with those in LHs (30.4 months vs. 18.5 months; p = .036). ConclusionOur series indicate that selected quality‐of‐care items were accomplished better by RCs over LHs, all with significant prognostic value in patients with STS. Early referral to an RC should be mandatory if the aim is to improve the survival of patients with STS.
Description
MeSH Terms
Biopsy
Cancer Care Facilities
Disease-Free Survival
Female
Follow-Up Studies
Humans
Male
Margins of Excision
Middle Aged
Neoplasm Recurrence, Local
Prognosis
Prospective Studies
Referral and Consultation
Registries
Sarcoma
Spain
Time Factors
Cancer Care Facilities
Disease-Free Survival
Female
Follow-Up Studies
Humans
Male
Margins of Excision
Middle Aged
Neoplasm Recurrence, Local
Prognosis
Prospective Studies
Referral and Consultation
Registries
Sarcoma
Spain
Time Factors
DeCS Terms
Pacientes
Sobrevida
Márgenes de escisión
Sarcoma
Quimioterapia
Neoplasias
Biopsia
Sobrevida
Márgenes de escisión
Sarcoma
Quimioterapia
Neoplasias
Biopsia
CIE Terms
Keywords
Diagnostic process, Multidisciplinary management, Outcome, Reference centers, Sarcoma
Citation
Martin-Broto J, Hindi N, Cruz J, Martinez-Trufero J, Valverde C, De Sande LM, et al. Relevance of Reference Centers in Sarcoma Care and Quality Item Evaluation: Results from the Prospective Registry of the Spanish Group for Research in Sarcoma (GEIS). Oncologist. 2019 Jun;24(6):e338-e346.